{"hospital_name":"Arizona General Hospital - Laveen Hospital","last_updated_on":"2024-11-25","version":"2.0.0","hospital_location": ["Arizona General Hospital - Laveen Hospital"],"hospital_address": ["7171 S 51st Ave, Phoenix, AZ 85339"],"license_information":{"license_number":"H6937","state":"AZ"},"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},"standard_charge_information":[{"description":"ADM SARSCOV2 30MCG/0.3ML 1ST","code_information":[{"code":"0001A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RBC DNA HEA 35 AG 11 BLD GRP","code_information":[{"code":"0001U","type":"CPT"}],"standard_charges":[{"minimum":1584,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1584,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ADM SARSCOV2 30MCG/0.3ML 2ND","code_information":[{"code":"0002A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER DIS 10 ASSAYS W/ASH","code_information":[{"code":"0002M","type":"CPT"}],"standard_charges":[{"minimum":1107.48,"maximum":1636.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1417.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1417.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1417.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1636.05,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1636.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1107.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC CLRCT 3 UR METAB ALG PLP","code_information":[{"code":"0002U","type":"CPT"}],"standard_charges":[{"minimum":55,"maximum":244.48,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":244.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":244.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":244.48,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":81.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":81.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FEE COVID-19 VAC 1 BOOSTER","code_information":[{"code":"0003A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER DIS 10 ASSAYS W/NASH","code_information":[{"code":"0003M","type":"CPT"}],"standard_charges":[{"minimum":327.83,"maximum":1636.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":327.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":327.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":327.83,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1636.05,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1636.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1107.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC OVAR 5 PRTN SER ALG SCOR","code_information":[{"code":"0003U","type":"CPT"}],"standard_charges":[{"minimum":244.48,"maximum":3087.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":244.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":244.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":244.48,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3087.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3087.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2090,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FEE COVID-19 VAC 1 RES","code_information":[{"code":"0004A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SCOLIOSIS DNA ALYS","code_information":[{"code":"0004M","type":"CPT"}],"standard_charges":[{"minimum":173.8,"maximum":409.77,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":409.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":409.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":409.77,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":173.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONCO PRST8 3 GENE UR ALG","code_information":[{"code":"0005U","type":"CPT"}],"standard_charges":[{"minimum":1337,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC HEP GENE RISK CLASSIFIER","code_information":[{"code":"0006M","type":"CPT"}],"standard_charges":[{"minimum":247.54,"maximum":487.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":247.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":247.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":247.54,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":487.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":330,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DETC IA MEDS 120+ ANALYTES","code_information":[{"code":"0006U","type":"CPT"}],"standard_charges":[{"minimum":543.22,"maximum":802.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":543.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC GASTRO 51 GENE NOMOGRAM","code_information":[{"code":"0007M","type":"CPT"}],"standard_charges":[{"minimum":70.29,"maximum":1218.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":70.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":70.29,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1218.75,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1218.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":825,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX TEST PRSMV UR W/DEF CONF","code_information":[{"code":"0007U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":371.9,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":322.26,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":322.26,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":322.26,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.9,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":371.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HPYLORI DETCJ ABX RSTNC DNA","code_information":[{"code":"0008U","type":"CPT"}],"standard_charges":[{"minimum":1315.4,"maximum":1943.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1683.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1683.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1683.7,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1943.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1943.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1315.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BRST CA ERBB2 AMP/NONAMP","code_information":[{"code":"0009U","type":"CPT"}],"standard_charges":[{"minimum":235.4,"maximum":377.23,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":377.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":377.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":377.23,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":235.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC","code_information":[{"code":"001","type":"MS-DRG"}],"standard_charges":[{"minimum":229129.28,"maximum":533463,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":411720.98,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":308800.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":308800.41,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":384718.82,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":384718.82,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":395314.38,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":469429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":387564,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":533463,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":229129.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":231420.58,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":236003.16,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":233711.87,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":229129.28,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":229129.28,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":229129.28,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":231420.58,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":229129.28,"methodology":"case rate"}]}]},{"description":"NFCT DS STRN TYP WHL GEN SEQ","code_information":[{"code":"0010U","type":"CPT"}],"standard_charges":[{"minimum":939.97,"maximum":1388.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1203.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1203.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1203.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1388.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1388.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":939.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0011","type":"APR-DRG"}],"standard_charges":[{"minimum":44527,"maximum":44527,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44527,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44527,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44527,"methodology":"case rate"}]}]},{"description":"ADM SARSCOV2 100MCG/0.5ML1ST","code_information":[{"code":"0011A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC PRST8 CA MRNA 12 GEN ALG","code_information":[{"code":"0011M","type":"CPT"}],"standard_charges":[{"minimum":1672,"maximum":1933.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1933.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1933.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1933.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX MNTR LC-MS/MS ORAL FLUID","code_information":[{"code":"0011U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":371.9,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":322.26,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":322.26,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":322.26,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.9,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":371.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0012","type":"APR-DRG"}],"standard_charges":[{"minimum":44527,"maximum":44527,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44527,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44527,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44527,"methodology":"case rate"}]}]},{"description":"ADM SARSCOV2 100MCG/0.5ML2ND","code_information":[{"code":"0012A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC MRNA 5 GEN RSK URTHL CA","code_information":[{"code":"0012M","type":"CPT"}],"standard_charges":[{"minimum":1672,"maximum":2140.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GERMLN DO GENE REARGMT DETCJ","code_information":[{"code":"0012U","type":"CPT"}],"standard_charges":[{"minimum":5534.32,"maximum":8175.7,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5534.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0013","type":"APR-DRG"}],"standard_charges":[{"minimum":52769,"maximum":52769,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":52769,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":52769,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":52769,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 2 BOOSTER","code_information":[{"code":"0013A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC MRNA 5 GEN RECR URTHL CA","code_information":[{"code":"0013M","type":"CPT"}],"standard_charges":[{"minimum":1337,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC SLD ORG NEO GENE REARGMT","code_information":[{"code":"0013U","type":"CPT"}],"standard_charges":[{"minimum":5534.32,"maximum":8175.7,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5534.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0014","type":"APR-DRG"}],"standard_charges":[{"minimum":111950,"maximum":111950,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":111950,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":111950,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":111950,"methodology":"case rate"}]}]},{"description":"LIVER DS ALYS 3 BMRK SRM ALG","code_information":[{"code":"0014M","type":"CPT"}],"standard_charges":[{"minimum":220.72,"maximum":387.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":220.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":220.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":220.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":387.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEM HMTLMF NEO GENE REARGMT","code_information":[{"code":"0014U","type":"CPT"}],"standard_charges":[{"minimum":5534.32,"maximum":8175.7,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5534.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ADRNL CORTCL TUM BCHM ASY 25","code_information":[{"code":"0015M","type":"CPT"}],"standard_charges":[{"minimum":213.92,"maximum":2871.81,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2871.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BLADDER MRNA 209 GEN ALG","code_information":[{"code":"0016M","type":"CPT"}],"standard_charges":[{"minimum":3797.08,"maximum":7677.19,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7677.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC HMTLMF NEO RNA BCR/ABL1","code_information":[{"code":"0016U","type":"CPT"}],"standard_charges":[{"minimum":360.71,"maximum":532.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":523.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":523.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":523.03,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":532.85,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":532.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":360.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC DLBCL MRNA 20 GENES ALG","code_information":[{"code":"0017M","type":"CPT"}],"standard_charges":[{"minimum":633.13,"maximum":5522.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":633.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":633.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":633.13,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5522.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC HMTLMF NEO JAK2 MUT DNA","code_information":[{"code":"0017U","type":"CPT"}],"standard_charges":[{"minimum":201.65,"maximum":297.9,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":297.9,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":297.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":201.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0018M","type":"CPT"}],"standard_charges":[{"minimum":879.48,"maximum":1409.61,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":879.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":879.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":879.48,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1409.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC THYR 10 MICRORNA SEQ ALG","code_information":[{"code":"0018U","type":"CPT"}],"standard_charges":[{"minimum":6604.6,"maximum":10137.55,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10137.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10137.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10137.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9756.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9756.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6604.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0019M","type":"CPT"}],"standard_charges":[{"minimum":594.24,"maximum":594.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":594.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":594.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":594.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC RNA TISS PREDICT ALG","code_information":[{"code":"0019U","type":"CPT"}],"standard_charges":[{"minimum":3037.66,"maximum":8085,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3037.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3037.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3037.66,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":8085,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC","code_information":[{"code":"002","type":"MS-DRG"}],"standard_charges":[{"minimum":120449.67,"maximum":289902.56,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":289902.56,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":217433.74,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":217433.74,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":173829.49,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":173829.49,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":178616.93,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":212105,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":175115,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":241037,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":120449.67,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":121654.17,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":124063.17,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":122858.67,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":120449.67,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":120449.67,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":120449.67,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":121654.17,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":120449.67,"methodology":"case rate"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0021","type":"APR-DRG"}],"standard_charges":[{"minimum":58849,"maximum":58849,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":58849,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":58849,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":58849,"methodology":"case rate"}]}]},{"description":"ONC PRST8 DETCJ 8 AUTOANTB","code_information":[{"code":"0021U","type":"CPT"}],"standard_charges":[{"minimum":1185.38,"maximum":2470,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1185.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1185.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1185.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2470,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2470,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0022","type":"APR-DRG"}],"standard_charges":[{"minimum":76126,"maximum":76126,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":76126,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":76126,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":76126,"methodology":"case rate"}]}]},{"description":"TRGT GEN SEQ DNARNA 23 GENE","code_information":[{"code":"0022U","type":"CPT"}],"standard_charges":[{"minimum":2173.35,"maximum":6337.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6337.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6337.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4290,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0023","type":"APR-DRG"}],"standard_charges":[{"minimum":90803,"maximum":90803,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":90803,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":90803,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":90803,"methodology":"case rate"}]}]},{"description":"ONC AML DNA DETCJ/NONDETCJ","code_information":[{"code":"0023U","type":"CPT"}],"standard_charges":[{"minimum":546.72,"maximum":807.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":602.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":602.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":602.22,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":807.65,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":807.65,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":546.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0024","type":"APR-DRG"}],"standard_charges":[{"minimum":172745,"maximum":172745,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":172745,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":172745,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":172745,"methodology":"case rate"}]}]},{"description":"GLYCA NUC MR SPECTRSC QUAN","code_information":[{"code":"0024U","type":"CPT"}],"standard_charges":[{"minimum":75.22,"maximum":126.9,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":126.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":126.9,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":111.1,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":111.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TENOFOVIR LIQ CHROM UR QUAN","code_information":[{"code":"0025U","type":"CPT"}],"standard_charges":[{"minimum":73.11,"maximum":278.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73.11,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":73.11,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":73.11,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":278.75,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":278.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":188.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC THYR DNAMRNA 112 GENES","code_information":[{"code":"0026U","type":"CPT"}],"standard_charges":[{"minimum":3428.41,"maximum":7920,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3428.41,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3428.41,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3428.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7920,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"JAK2 GENE TRGT SEQ ALYS","code_information":[{"code":"0027U","type":"CPT"}],"standard_charges":[{"minimum":268.2,"maximum":440.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":440.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":440.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":268.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX MTAB ADVERSE TRGT SEQ ANLS","code_information":[{"code":"0029U","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":667.8,"maximum":1029.42,"gross_charge":1260,"discounted_cash":504,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":667.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1029.42,"methodology":"fee schedule"}]}]},{"description":"RX MTAB ADVERSE TRGT SEQ ANLS","code_information":[{"code":"0029U","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":667.8,"maximum":1029.42,"gross_charge":1260,"discounted_cash":504,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":667.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1029.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":764.54,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":764.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":764.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":742.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":749.7,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":764.54,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":757.12,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":742.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":742.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":742.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":749.7,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":742.27,"methodology":"fee schedule"}]}]},{"description":"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES","code_information":[{"code":"003","type":"MS-DRG"}],"standard_charges":[{"minimum":186853.65,"maximum":390049.87,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":367615.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":275719.95,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":275719.95,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":302684.3,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":302684.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":311020.54,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":390049.87,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":390049.87,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":390049.87,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":186853.65,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":188722.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":192459.26,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":190590.73,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":186853.65,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":186853.65,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":186853.65,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":188722.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":186853.65,"methodology":"case rate"}]}]},{"description":"RX METAB WARF TRGT SEQ ALYS","code_information":[{"code":"0030U","type":"CPT"}],"standard_charges":[{"minimum":295.09,"maximum":707.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":707.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":707.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":707.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":295.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FEE COVID-19 VAC 4 DOSE 1","code_information":[{"code":"0031A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYP1A2 GENE","code_information":[{"code":"0031U","type":"CPT"}],"standard_charges":[{"minimum":384.58,"maximum":635.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":384.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"COMT GENE","code_information":[{"code":"0032U","type":"CPT"}],"standard_charges":[{"minimum":384.58,"maximum":635.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":384.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HTR2A HTR2C GENES","code_information":[{"code":"0033U","type":"CPT"}],"standard_charges":[{"minimum":635.42,"maximum":769.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":635.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":769.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FEE COVID-19 VAC 4 RES","code_information":[{"code":"0034A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TPMT NUDT15 GENES","code_information":[{"code":"0034U","type":"CPT"}],"standard_charges":[{"minimum":1025.57,"maximum":1515.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1487.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1487.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1487.13,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1515.05,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1515.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1025.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEURO CSF PRION PRTN QUAL","code_information":[{"code":"0035U","type":"CPT"}],"standard_charges":[{"minimum":30.94,"maximum":1758.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":30.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":30.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1758.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1758.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1190.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"XOME TUM  NML SPEC SEQ ALYS","code_information":[{"code":"0036U","type":"CPT"}],"standard_charges":[{"minimum":10516,"maximum":17253.99,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17253.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":17253.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":17253.99,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10516,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRGT GENOMIC SEQ/DNA ANLS 324","code_information":[{"code":"0037U","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":7791,"maximum":12009.9,"gross_charge":14700,"discounted_cash":5880,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":7791,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":12009.9,"methodology":"fee schedule"}]}]},{"description":"TRGT GENOMIC SEQ/DNA ANLS 324","code_information":[{"code":"0037U","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":3500,"maximum":12009.9,"gross_charge":14700,"discounted_cash":5880,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":7791,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":12009.9,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3605,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3605,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3605,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3500,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3535,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3605,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3570,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3500,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3500,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3500,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3535,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3500,"methodology":"fee schedule"}]}]},{"description":"VITAMIN D SRM MICROSAMP QUAN","code_information":[{"code":"0038U","type":"CPT"}],"standard_charges":[{"minimum":65.12,"maximum":96.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":96.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":96.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":96.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":96.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":96.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":65.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DNA ANTB 2STRAND HI AVIDITY","code_information":[{"code":"0039U","type":"CPT"}],"standard_charges":[{"minimum":30.23,"maximum":50.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":50.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":50.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44.65,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":44.65,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":30.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES","code_information":[{"code":"004","type":"MS-DRG"}],"standard_charges":[{"minimum":138417.71,"maximum":324473,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":222162.92,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":166627.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":166627.41,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208695.9,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":208695.9,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":214443.6,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":283328,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":324473,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":210239,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":138417.71,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":139801.89,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":142570.25,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":141186.07,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":138417.71,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":138417.71,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":138417.71,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":139801.89,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":138417.71,"methodology":"case rate"}]}]},{"description":"BCR/ABL1 GENE MAJOR BP QUAN","code_information":[{"code":"0040U","type":"CPT"}],"standard_charges":[{"minimum":730.65,"maximum":1332.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":730.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":730.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":730.65,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1332.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1332.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":901.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0041","type":"APR-DRG"}],"standard_charges":[{"minimum":41935,"maximum":41935,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":41935,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":41935,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":41935,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 5 DOSE 1","code_information":[{"code":"0041A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"B BRGDRFERI ANTB 5 PRTN IGM","code_information":[{"code":"0041U","type":"CPT"}],"standard_charges":[{"minimum":37.86,"maximum":56.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":55.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0042","type":"APR-DRG"}],"standard_charges":[{"minimum":49783,"maximum":49783,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":49783,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":49783,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":49783,"methodology":"case rate"}]}]},{"description":"ADMN SARSCV2 VAC5MCG 2NDDOSE","code_information":[{"code":"0042A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":83.74,"maximum":129.086,"gross_charge":158,"discounted_cash":63.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":83.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":129.09,"methodology":"fee schedule"}]}]},{"description":"ADMN SARSCV2 VAC5MCG 2NDDOSE","code_information":[{"code":"0042A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":40.57,"maximum":129.086,"gross_charge":158,"discounted_cash":63.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":83.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":129.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42.94,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43.79,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43.37,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42.94,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"}]}]},{"description":"CT PERFUSION W/CONTRAST CBF","code_information":[{"code":"0042T","type":"CPT"}],"standard_charges":[{"minimum":139.72,"maximum":304.61,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":304.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":304.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":304.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":139.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"B BRGDRFERI ANTB 12 PRTN IGG","code_information":[{"code":"0042U","type":"CPT"}],"standard_charges":[{"minimum":37.86,"maximum":56.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":55.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0043","type":"APR-DRG"}],"standard_charges":[{"minimum":71072,"maximum":71072,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":71072,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":71072,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":71072,"methodology":"case rate"}]}]},{"description":"TBRF B GRP ANTB 4 PRTN IGM","code_information":[{"code":"0043U","type":"CPT"}],"standard_charges":[{"minimum":32.69,"maximum":48.78,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":48.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":48.78,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.3,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":48.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":32.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0044","type":"APR-DRG"}],"standard_charges":[{"minimum":103939,"maximum":103939,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":103939,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":103939,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":103939,"methodology":"case rate"}]}]},{"description":"ADMN SARSCV2 VAC5MCG BSTR","code_information":[{"code":"0044A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":83.74,"maximum":129.086,"gross_charge":158,"discounted_cash":63.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":83.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":129.09,"methodology":"fee schedule"}]}]},{"description":"ADMN SARSCV2 VAC5MCG BSTR","code_information":[{"code":"0044A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":40.57,"maximum":129.086,"gross_charge":158,"discounted_cash":63.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":83.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":129.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42.94,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43.79,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43.37,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42.94,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42.51,"methodology":"fee schedule"}]}]},{"description":"TBRF B GRP ANTB 4 PRTN IGG","code_information":[{"code":"0044U","type":"CPT"}],"standard_charges":[{"minimum":32.69,"maximum":48.78,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":48.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":48.78,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.3,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":48.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":32.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANESTH SURGERY OF SHOULDER","code_information":[{"code":"00450","type":"CPT"}],"standard_charges":[{"minimum":573,"maximum":573,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00451","type":"CPT"}],"standard_charges":[{"minimum":573,"maximum":573,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00452","type":"CPT"}],"standard_charges":[{"minimum":573,"maximum":573,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":573,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BRST DUX CARC IS 12 GENE","code_information":[{"code":"0045U","type":"CPT"}],"standard_charges":[{"minimum":8520.6,"maximum":12587.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11247.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11247.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11247.57,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12587.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12587.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":8520.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FLT3 GENE ITD VARIANTS QUAN","code_information":[{"code":"0046U","type":"CPT"}],"standard_charges":[{"minimum":523.03,"maximum":896.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":523.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":523.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":523.03,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":538.35,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":538.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":896.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC PRST8 MRNA 17 GENE ALG","code_information":[{"code":"0047U","type":"CPT"}],"standard_charges":[{"minimum":8520.6,"maximum":12587.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11435.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11435.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11435.7,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12587.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12587.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":8520.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC SLD ORG NEO DNA 468 GENE","code_information":[{"code":"0048U","type":"CPT"}],"standard_charges":[{"minimum":6423.12,"maximum":10538.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10538.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10538.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10538.65,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9488.7,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9488.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6423.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NPM1 GENE ANALYSIS QUAN","code_information":[{"code":"0049U","type":"CPT"}],"standard_charges":[{"minimum":786.42,"maximum":896.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":786.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":786.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":786.42,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":801.1,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":801.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":896.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT","code_information":[{"code":"005","type":"MS-DRG"}],"standard_charges":[{"minimum":106591.91,"maximum":208549.91,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208549.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":156417.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":156417.34,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":146938.95,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":146938.95,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":150985.8,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":179293,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":148026,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":203750,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":106591.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":107657.83,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":109789.67,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":108723.75,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":106591.91,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":106591.91,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":106591.91,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":107657.83,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":106591.91,"methodology":"case rate"}]}]},{"description":"TRGT GEN SEQ DNA 194 GENES","code_information":[{"code":"0050U","type":"CPT"}],"standard_charges":[{"minimum":6416.52,"maximum":9478.95,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9313.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9313.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9313.77,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9478.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9478.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6416.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0051","type":"APR-DRG"}],"standard_charges":[{"minimum":27708,"maximum":27708,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":27708,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":27708,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":27708,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 6 DOSE 1","code_information":[{"code":"0051A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX MNTR LC-MS/MS UR 31 PNL","code_information":[{"code":"0051U","type":"CPT"}],"standard_charges":[{"minimum":426.16,"maximum":637.94,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":637.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":637.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":637.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":629.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":629.55,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":426.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0052","type":"APR-DRG"}],"standard_charges":[{"minimum":37716,"maximum":37716,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":37716,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":37716,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":37716,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 6 DOSE 2","code_information":[{"code":"0052A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LPOPRTN BLD W/5 MAJ CLASSES","code_information":[{"code":"0052U","type":"CPT"}],"standard_charges":[{"minimum":74.49,"maximum":95.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":95.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":95.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":95.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":74.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0053","type":"APR-DRG"}],"standard_charges":[{"minimum":47950,"maximum":47950,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":47950,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":47950,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":47950,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 6 BOOSTER","code_information":[{"code":"0053A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC PRST8 CA FISH ALYS 4 GEN","code_information":[{"code":"0053U","type":"CPT"}],"standard_charges":[{"minimum":4466,"maximum":6597.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6597.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6597.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4466,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0054","type":"APR-DRG"}],"standard_charges":[{"minimum":68217,"maximum":68217,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":68217,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":68217,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":68217,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 6 RES","code_information":[{"code":"0054A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BONE SRGRY CMPTR FLUOR IMAGE","code_information":[{"code":"0054T","type":"CPT"}],"standard_charges":[{"minimum":239.82,"maximum":1512.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":239.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX MNTR 14+ DRUGS  SBSTS","code_information":[{"code":"0054U","type":"CPT"}],"standard_charges":[{"minimum":327.71,"maximum":637.94,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":637.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":637.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":637.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":484.1,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":484.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":327.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BONE SRGRY CMPTR CT/MRI IMAG","code_information":[{"code":"0055T","type":"CPT"}],"standard_charges":[{"minimum":482.94,"maximum":1512.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":482.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CARD HRT TRNSPL 96 DNA SEQ","code_information":[{"code":"0055U","type":"CPT"}],"standard_charges":[{"minimum":7128,"maximum":10530,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9566.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9566.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9566.66,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10530,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10530,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7128,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEM AML DNA GENE REARGMT","code_information":[{"code":"0056U","type":"CPT"}],"standard_charges":[{"minimum":5534.32,"maximum":8175.7,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":8175.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5534.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC MERKEL CLL CARC SRM QUAN","code_information":[{"code":"0058U","type":"CPT"}],"standard_charges":[{"minimum":710.51,"maximum":3797.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1049.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1049.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":710.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC MERKEL CLL CARC SRM +/-","code_information":[{"code":"0059U","type":"CPT"}],"standard_charges":[{"minimum":710.51,"maximum":3797.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1049.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1049.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":710.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER TRANSPLANT WITHOUT MCC","code_information":[{"code":"006","type":"MS-DRG"}],"standard_charges":[{"minimum":66256.55,"maximum":142600.03,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142600.03,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":106953.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":106953.37,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68669.47,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":68669.47,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":70560.7,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83790,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":69177,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":95219,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":66256.55,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":66919.12,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":68244.25,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":67581.69,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":66256.55,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":66256.55,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":66256.55,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":66919.12,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":66256.55,"methodology":"case rate"}]}]},{"description":"TWN ZYG GEN SEQ ALYS CHRMS2","code_information":[{"code":"0060U","type":"CPT"}],"standard_charges":[{"minimum":1669.91,"maximum":3797.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2466.9,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2466.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1669.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0061","type":"APR-DRG"}],"standard_charges":[{"minimum":49905,"maximum":49905,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":49905,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":49905,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":49905,"methodology":"case rate"}]}]},{"description":"TC MEAS 5 BMRK SFDI M-S ALYS","code_information":[{"code":"0061U","type":"CPT"}],"standard_charges":[{"minimum":55.22,"maximum":2367.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":81.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":81.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":55.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0062","type":"APR-DRG"}],"standard_charges":[{"minimum":49905,"maximum":49905,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":49905,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":49905,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":49905,"methodology":"case rate"}]}]},{"description":"AI SLE IGGIGM ALYS 80 BMRK","code_information":[{"code":"0062U","type":"CPT"}],"standard_charges":[{"minimum":837.58,"maximum":1072.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1072.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1072.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1072.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":837.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0063","type":"APR-DRG"}],"standard_charges":[{"minimum":55672,"maximum":55672,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":55672,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":55672,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":55672,"methodology":"case rate"}]}]},{"description":"NEURO AUTISM 32 AMINES ALG","code_information":[{"code":"0063U","type":"CPT"}],"standard_charges":[{"minimum":1650,"maximum":2112,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2112,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2112,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2112,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1650,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0064","type":"APR-DRG"}],"standard_charges":[{"minimum":92525,"maximum":92525,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":92525,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":92525,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":92525,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00646","type":"CPT"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00647","type":"CPT"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00648","type":"CPT"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00649","type":"CPT"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FEE COVID-19 VAC 7 RES","code_information":[{"code":"0064A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANTB TP TOTALRPR IA QUAL","code_information":[{"code":"0064U","type":"CPT"}],"standard_charges":[{"minimum":68.93,"maximum":101.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":88.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":88.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":101.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":101.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":68.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SYFLS TST NONTREPONEMAL ANTB","code_information":[{"code":"0065U","type":"CPT"}],"standard_charges":[{"minimum":39.8,"maximum":58.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":50.96,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":58.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":39.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PAMG-1 IA CERVICO-VAG FLUID","code_information":[{"code":"0066U","type":"CPT"}],"standard_charges":[{"minimum":33.64,"maximum":33.64,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":33.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BRST IMHCHEM PRFL 4 BMRK","code_information":[{"code":"0067U","type":"CPT"}],"standard_charges":[{"minimum":4173.4,"maximum":5341.93,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5341.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5341.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5341.93,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4173.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00681","type":"CPT"}],"standard_charges":[{"minimum":9129.8,"maximum":9129.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9129.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9129.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9129.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CANDIDA SPECIES PNL AMP PRB","code_information":[{"code":"0068U","type":"CPT"}],"standard_charges":[{"minimum":313.79,"maximum":463.55,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":463.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":463.55,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":313.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC CLRCT MICRORNA MIR-31-3P","code_information":[{"code":"0069U","type":"CPT"}],"standard_charges":[{"minimum":836,"maximum":1235,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1212.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1212.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1212.24,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1235,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1235,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":836,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LUNG TRANSPLANT","code_information":[{"code":"007","type":"MS-DRG"}],"standard_charges":[{"minimum":120612.82,"maximum":241476,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201492.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":151124.46,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":151124.46,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":174146.08,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":174146.08,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":178942.24,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":212491,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":175434,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":241476,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":120612.82,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":121818.95,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":124231.21,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":123025.08,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":120612.82,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":120612.82,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":120612.82,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":121818.95,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":120612.82,"methodology":"case rate"}]}]},{"description":"CYP2D6 GEN COMSLCT RAR VRNT","code_information":[{"code":"0070U","type":"CPT"}],"standard_charges":[{"minimum":1488.01,"maximum":2198.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1904.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1904.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1904.65,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2198.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2198.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1488.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0071","type":"APR-DRG"}],"standard_charges":[{"minimum":38654,"maximum":38654,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38654,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38654,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38654,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 8 DOSE 1","code_information":[{"code":"0071A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"US LEIOMYOMATA ABLATE <200","code_information":[{"code":"0071T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3989.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYP2D6 FULL GENE SEQUENCE","code_information":[{"code":"0071U","type":"CPT"}],"standard_charges":[{"minimum":979.4,"maximum":1914.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1914.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1914.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1914.05,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":979.4,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":979.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0072","type":"APR-DRG"}],"standard_charges":[{"minimum":56005,"maximum":56005,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":56005,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":56005,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":56005,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00720","type":"CPT"}],"standard_charges":[{"minimum":1719,"maximum":1719,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1719,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1719,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1719,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"00721","type":"CPT"}],"standard_charges":[{"minimum":1719,"maximum":1719,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1719,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1719,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1719,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FEE COVID-19 VAC 8 DOSE 2","code_information":[{"code":"0072A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"US LEIOMYOMATA ABLATE >200","code_information":[{"code":"0072T","type":"CPT"}],"standard_charges":[{"minimum":1649.36,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1649.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYP2D6 GEN CYP2D6-2D7 HYBRID","code_information":[{"code":"0072U","type":"CPT"}],"standard_charges":[{"minimum":992,"maximum":1465.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":992,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0073","type":"APR-DRG"}],"standard_charges":[{"minimum":67436,"maximum":67436,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":67436,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":67436,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":67436,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 8 BOOSTER","code_information":[{"code":"0073A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYP2D6 GEN CYP2D7-2D6 HYBRID","code_information":[{"code":"0073U","type":"CPT"}],"standard_charges":[{"minimum":992,"maximum":1465.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":992,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0074","type":"APR-DRG"}],"standard_charges":[{"minimum":131015,"maximum":131015,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":131015,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":131015,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":131015,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 8 RES","code_information":[{"code":"0074A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYP2D6 NONDUPLICATED GENE","code_information":[{"code":"0074U","type":"CPT"}],"standard_charges":[{"minimum":992,"maximum":1465.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":992,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ STENT/CHEST VERT ART","code_information":[{"code":"0075T","type":"CPT"}],"standard_charges":[{"minimum":2475.46,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2475.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYP2D6 5 GENE DUP/MLT","code_information":[{"code":"0075U","type":"CPT"}],"standard_charges":[{"minimum":992,"maximum":1465.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":992,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SI STENT/CHEST VERT ART","code_information":[{"code":"0076T","type":"CPT"}],"standard_charges":[{"minimum":1364.51,"maximum":2945.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1364.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYP2D6 3 GENE DUP/MLT","code_information":[{"code":"0076U","type":"CPT"}],"standard_charges":[{"minimum":992,"maximum":1465.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":992,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IG PARAPROTEIN QUAL BLD/UR","code_information":[{"code":"0077U","type":"CPT"}],"standard_charges":[{"minimum":95.55,"maximum":122.32,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":122.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":122.32,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":95.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PAIN MGT OPI USE GNOTYP PNL","code_information":[{"code":"0078U","type":"CPT"}],"standard_charges":[{"minimum":992,"maximum":1465.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":992,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CMPRTV DNA ALYS MLT SNPS","code_information":[{"code":"0079U","type":"CPT"}],"standard_charges":[{"minimum":3663.8,"maximum":3663.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3663.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3663.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3663.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT","code_information":[{"code":"008","type":"MS-DRG"}],"standard_charges":[{"minimum":69364.5,"maximum":167800.21,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":167800.21,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":125854.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":125854.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":74700.35,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":74700.35,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":76757.68,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":91148,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":75253,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":103582,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":69364.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":70058.15,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":71445.44,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":70751.79,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":69364.5,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":69364.5,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":69364.5,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":70058.15,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":69364.5,"methodology":"case rate"}]}]},{"description":"ONC LNG 5 CLIN RSK FACTR ALG","code_information":[{"code":"0080U","type":"CPT"}],"standard_charges":[{"minimum":7744,"maximum":11440,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9912.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9912.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9912.29,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11440,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11440,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7744,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0081","type":"APR-DRG"}],"standard_charges":[{"minimum":26320,"maximum":26320,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26320,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26320,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26320,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 9 DOSE 1","code_information":[{"code":"0081A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0082","type":"APR-DRG"}],"standard_charges":[{"minimum":31589,"maximum":31589,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":31589,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":31589,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":31589,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 9 DOSE 2","code_information":[{"code":"0082A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX TEST DEF 90+ RX/SBSTS UR","code_information":[{"code":"0082U","type":"CPT"}],"standard_charges":[{"minimum":212.09,"maximum":802.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":212.09,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":212.09,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":212.09,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":543.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0083","type":"APR-DRG"}],"standard_charges":[{"minimum":37024,"maximum":37024,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":37024,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":37024,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":37024,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 9 BOOSTER","code_information":[{"code":"0083A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC RSPSE CHEMO CNTRST TOMOG","code_information":[{"code":"0083U","type":"CPT"}],"standard_charges":[{"minimum":368.17,"maximum":471.27,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":471.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":471.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":471.27,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":368.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0084","type":"APR-DRG"}],"standard_charges":[{"minimum":59102,"maximum":59102,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":59102,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":59102,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":59102,"methodology":"case rate"}]}]},{"description":"RBC DNA GNOTYP 10 BLD GROUPS","code_information":[{"code":"0084U","type":"CPT"}],"standard_charges":[{"minimum":1584,"maximum":2340,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2340,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2340,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1584,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANESTH TUBAL LIGATION","code_information":[{"code":"00851","type":"CPT"}],"standard_charges":[{"minimum":668.5,"maximum":668.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":668.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":668.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":668.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NFCT DS BACTFNG ORG ID 6+","code_information":[{"code":"0086U","type":"CPT"}],"standard_charges":[{"minimum":440,"maximum":563.18,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":563.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":563.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":563.18,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":440,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRD HRT TRNSPL MRNA 1283 GEN","code_information":[{"code":"0087U","type":"CPT"}],"standard_charges":[{"minimum":6950.72,"maximum":10078.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10078.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10078.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10078.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6950.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRNSPLJ KDN ALGRFT REJ 1494","code_information":[{"code":"0088U","type":"CPT"}],"standard_charges":[{"minimum":6950.72,"maximum":10078.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10078.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10078.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10078.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6950.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC MLNMA PRAME  LINC00518","code_information":[{"code":"0089U","type":"CPT"}],"standard_charges":[{"minimum":1672,"maximum":2470,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2470,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2470,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC CUTAN MLNMA MRNA 23 GENE","code_information":[{"code":"0090U","type":"CPT"}],"standard_charges":[{"minimum":3861,"maximum":6337.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5224.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5224.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5224.46,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6337.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6337.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3861,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0091","type":"APR-DRG"}],"standard_charges":[{"minimum":31367,"maximum":31367,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":31367,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":31367,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":31367,"methodology":"case rate"}]}]},{"description":"ANESTH BLADDER TUMOR SURG","code_information":[{"code":"00912","type":"CPT"}],"standard_charges":[{"minimum":1184.2,"maximum":1184.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1184.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1184.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1184.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FEE COVID-19 VAC 10 DOSE 1","code_information":[{"code":"0091A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC CLRCT SCR WHL BLD ALG","code_information":[{"code":"0091U","type":"CPT"}],"standard_charges":[{"minimum":226.79,"maximum":226.79,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0092","type":"APR-DRG"}],"standard_charges":[{"minimum":31367,"maximum":31367,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":31367,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":31367,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":31367,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 10 DOSE 2","code_information":[{"code":"0092A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC LNG 3 PRTN BMRK PLSM ALG","code_information":[{"code":"0092U","type":"CPT"}],"standard_charges":[{"minimum":5473.6,"maximum":7006.19,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7006.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7006.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7006.19,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5473.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0093","type":"APR-DRG"}],"standard_charges":[{"minimum":52395,"maximum":52395,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":52395,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":52395,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":52395,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 10 BOOSTER","code_information":[{"code":"0093A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX MNTR 65 COM DRUGS URINE","code_information":[{"code":"0093U","type":"CPT"}],"standard_charges":[{"minimum":136.71,"maximum":201.95,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":174.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":174.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":174.99,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":201.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":136.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0094","type":"APR-DRG"}],"standard_charges":[{"minimum":118382,"maximum":118382,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":118382,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":118382,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":118382,"methodology":"case rate"}]}]},{"description":"FEE COVID-19 VAC 10 RES","code_information":[{"code":"0094A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GENOME RAPID SEQUENCE ALYS","code_information":[{"code":"0094U","type":"CPT"}],"standard_charges":[{"minimum":16680.84,"maximum":24187.82,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24187.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":24187.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":24187.82,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16680.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL ARTIFIC DISC ADDL CRVCL","code_information":[{"code":"0095T","type":"CPT"}],"standard_charges":[{"minimum":2444.35,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2444.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INFLM EE ELISA ALYS ALG","code_information":[{"code":"0095U","type":"CPT"}],"standard_charges":[{"minimum":1698.36,"maximum":2173.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2173.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2173.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2173.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1698.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HPV HI RISK TYPES MALE URINE","code_information":[{"code":"0096U","type":"CPT"}],"standard_charges":[{"minimum":77.2,"maximum":114.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.05,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":114.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":77.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GI PATHOGEN 22 TARGETS","code_information":[{"code":"0097U","type":"CPT"}],"standard_charges":[{"minimum":798.69,"maximum":798.69,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":798.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REV ARTIFIC DISC ADDL","code_information":[{"code":"0098T","type":"CPT"}],"standard_charges":[{"minimum":1520.66,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1520.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RESPIR PATHOGEN 14 TARGETS","code_information":[{"code":"0098U","type":"CPT"}],"standard_charges":[{"minimum":545.2,"maximum":545.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":545.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RESPIR PATHOGEN 20 TARGETS","code_information":[{"code":"0099U","type":"CPT"}],"standard_charges":[{"minimum":605.77,"maximum":605.77,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":605.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"010","type":"MS-DRG"}],"standard_charges":[{"minimum":66086.08,"maximum":129328.38,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":129328.38,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":96999.33,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":96999.33,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68338.68,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":68338.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":70220.8,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83386,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":68844,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":94761,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":66086.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":66746.95,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":68068.67,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":67407.81,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":66086.08,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":66086.08,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":66086.08,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":66746.95,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":66086.08,"methodology":"case rate"}]}]},{"description":"PROSTH RETINA RECEIVEGEN","code_information":[{"code":"0100T","type":"CPT"}],"standard_charges":[{"minimum":4030.77,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4030.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RESPIR PATHOGEN 21 TARGETS","code_information":[{"code":"0100U","type":"CPT"}],"standard_charges":[{"minimum":656.92,"maximum":656.92,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":656.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACORP SHOCKWV TX HI ENRG","code_information":[{"code":"0101T","type":"CPT"}],"standard_charges":[{"minimum":31.26,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":31.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED COLON CA DO 15 GENES","code_information":[{"code":"0101U","type":"CPT"}],"standard_charges":[{"minimum":3801.85,"maximum":5563.33,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5563.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5563.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5563.33,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3801.85,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3801.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3836.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACORP SHOCKWV TX ANESTH","code_information":[{"code":"0102T","type":"CPT"}],"standard_charges":[{"minimum":833.34,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":833.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED BRST CA RLTD DO 17 GEN","code_information":[{"code":"0102U","type":"CPT"}],"standard_charges":[{"minimum":2868.69,"maximum":4159.71,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4159.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4159.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4159.71,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3633.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3633.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2868.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED OVA CA PNL 24 GENES","code_information":[{"code":"0103U","type":"CPT"}],"standard_charges":[{"minimum":3633.45,"maximum":4910.95,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4910.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4910.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4910.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3633.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3633.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3836.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEPH CKD MULT ECLIA TUM NEC","code_information":[{"code":"0105U","type":"CPT"}],"standard_charges":[{"minimum":2090,"maximum":3087.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2675.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2675.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2675.22,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3087.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3087.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2090,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TOUCH QUANT SENSORY TEST","code_information":[{"code":"0106T","type":"CPT"}],"standard_charges":[{"minimum":8.37,"maximum":95.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8.37,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":95.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GSTR EMPTG 7 TIMED BRTH SPEC","code_information":[{"code":"0106U","type":"CPT"}],"standard_charges":[{"minimum":1923.88,"maximum":2462.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2462.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2462.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2462.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1923.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIBRATE QUANT SENSORY TEST","code_information":[{"code":"0107T","type":"CPT"}],"standard_charges":[{"minimum":77.42,"maximum":151.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":151.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":151.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":77.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"C DIFF TOX AG DETCJ IA STOOL","code_information":[{"code":"0107U","type":"CPT"}],"standard_charges":[{"minimum":35.2,"maximum":52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":45.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":45.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":35.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"COOL QUANT SENSORY TEST","code_information":[{"code":"0108T","type":"CPT"}],"standard_charges":[{"minimum":77.42,"maximum":151.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":151.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":151.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":77.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GI BARRETT ESOPH 9 PRTN BMRK","code_information":[{"code":"0108U","type":"CPT"}],"standard_charges":[{"minimum":10890,"maximum":15790.93,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15790.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15790.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15790.93,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10890,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEAT QUANT SENSORY TEST","code_information":[{"code":"0109T","type":"CPT"}],"standard_charges":[{"minimum":77.42,"maximum":77.42,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":77.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ID ASPERGILLUS DNA 4 SPECIES","code_information":[{"code":"0109U","type":"CPT"}],"standard_charges":[{"minimum":313.79,"maximum":463.55,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":463.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":463.55,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":313.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC","code_information":[{"code":"011","type":"MS-DRG"}],"standard_charges":[{"minimum":59731.47,"maximum":101507,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":79639.46,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":59731.47,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":59731.47,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73203.99,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":73203.99,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75220.1,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":89323,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":73745,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":101507,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":68593.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":69279.31,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":70651.18,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":69965.24,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":68593.37,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":68593.37,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":68593.37,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":69279.31,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":68593.37,"methodology":"case rate"}]}]},{"description":"NOS QUANT SENSORY TEST","code_information":[{"code":"0110T","type":"CPT"}],"standard_charges":[{"minimum":95.5,"maximum":307.93,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":307.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":307.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":307.93,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":95.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX MNTR 1+ORAL ONC RXSBSTS","code_information":[{"code":"0110U","type":"CPT"}],"standard_charges":[{"minimum":59.64,"maximum":88.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":76.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":76.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":76.36,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.1,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":88.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":59.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0111A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC COLON CA KRASNRAS ALYS","code_information":[{"code":"0111U","type":"CPT"}],"standard_charges":[{"minimum":1501.04,"maximum":2217.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2176.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2176.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2176.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2217.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2217.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1501.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0112A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IADI 16S18S RRNA GENES","code_information":[{"code":"0112U","type":"CPT"}],"standard_charges":[{"minimum":783.49,"maximum":1002.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":783.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0113A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC PRST8 PCA3TMPRSS2-ERG","code_information":[{"code":"0113U","type":"CPT"}],"standard_charges":[{"minimum":1672,"maximum":2470,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2470,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2470,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GI BARRETTS ESOPH VIMCCNA1","code_information":[{"code":"0114U","type":"CPT"}],"standard_charges":[{"minimum":4263.62,"maximum":6182.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6182.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":6182.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":6182.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4263.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RESPIR IADNA 18 VIRAL2 BACT","code_information":[{"code":"0115U","type":"CPT"}],"standard_charges":[{"minimum":605.77,"maximum":775.38,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":775.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":775.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":775.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":605.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX MNTR NZM IA 35+ORAL FLU","code_information":[{"code":"0116U","type":"CPT"}],"standard_charges":[{"minimum":543.22,"maximum":802.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":695.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":695.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":695.32,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":802.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":543.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PAIN MGMT 11 ENDOGENOUS ANAL","code_information":[{"code":"0117U","type":"CPT"}],"standard_charges":[{"minimum":1849.43,"maximum":2681.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2681.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2681.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2681.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1849.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRNSPLJ DON-DRV CLL-FR DNA","code_information":[{"code":"0118U","type":"CPT"}],"standard_charges":[{"minimum":5258.73,"maximum":6057.15,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5258.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5258.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5258.73,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6057.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRD CERAMIDES LIQ CHROM PLSM","code_information":[{"code":"0119U","type":"CPT"}],"standard_charges":[{"minimum":184.27,"maximum":235.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":235.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":235.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":235.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":184.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC","code_information":[{"code":"012","type":"MS-DRG"}],"standard_charges":[{"minimum":46757.7,"maximum":78840,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":62341.65,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":46757.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":46757.7,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56857.57,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":56857.57,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":58423.48,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69377,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":57278,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":78840,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":60169.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":60771.11,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":61974.5,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":61372.8,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":60169.41,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":60169.41,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":60169.41,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":60771.11,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":60169.41,"methodology":"case rate"}]}]},{"description":"ONC B CLL LYMPHM MRNA 58 GEN","code_information":[{"code":"0120U","type":"CPT"}],"standard_charges":[{"minimum":5522.46,"maximum":9064.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8007.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8007.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8007.79,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9064.65,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9064.65,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5522.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SC DIS VCAM-1 WHOLE BLOOD","code_information":[{"code":"0121U","type":"CPT"}],"standard_charges":[{"minimum":1120.24,"maximum":1433.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1433.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1433.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1433.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1120.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SC DIS P-SELECTIN WHL BLOOD","code_information":[{"code":"0122U","type":"CPT"}],"standard_charges":[{"minimum":1157.71,"maximum":1481.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1481.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1481.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1481.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1157.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MCHNL FRAGILITY RBC PRFLG","code_information":[{"code":"0123U","type":"CPT"}],"standard_charges":[{"minimum":786.79,"maximum":1007.07,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1007.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1007.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1007.07,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":786.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0124A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FTL CGEN ABNOR 3 ANALTYES","code_information":[{"code":"0124U","type":"CPT"}],"standard_charges":[{"minimum":122.19,"maximum":180.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":122.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FTL CGEN ABNOR PRNT COMP 5","code_information":[{"code":"0125U","type":"CPT"}],"standard_charges":[{"minimum":152.94,"maximum":225.95,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":225.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":225.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":152.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FTL CGEN ABNOR PRNT COMP 5 Y","code_information":[{"code":"0126U","type":"CPT"}],"standard_charges":[{"minimum":152.94,"maximum":225.95,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":225.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":225.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":152.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OB PE 3 ANALYTES","code_information":[{"code":"0127U","type":"CPT"}],"standard_charges":[{"minimum":122.19,"maximum":180.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":122.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OB PE 3 ANALYTES Y CHRMSM","code_information":[{"code":"0128U","type":"CPT"}],"standard_charges":[{"minimum":122.19,"maximum":180.5,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":122.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED BRST CA RLTD DO PANEL","code_information":[{"code":"0129U","type":"CPT"}],"standard_charges":[{"minimum":2868.69,"maximum":4159.71,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4159.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4159.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4159.71,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3633.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3633.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2868.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC","code_information":[{"code":"013","type":"MS-DRG"}],"standard_charges":[{"minimum":38128.88,"maximum":52871,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51376.59,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":38533.65,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":38533.65,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38128.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":38128.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":39178.99,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46524,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":38411,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":52871,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":50517.78,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":51022.96,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":52033.32,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":51528.14,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":50517.78,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":50517.78,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":50517.78,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":51022.96,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":50517.78,"methodology":"case rate"}]}]},{"description":"HERED COLON CA DO MRNA PNL","code_information":[{"code":"0130U","type":"CPT"}],"standard_charges":[{"minimum":1286.78,"maximum":1900.95,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1900.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1900.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1286.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED BRST CA RLTD DO PNL 13","code_information":[{"code":"0131U","type":"CPT"}],"standard_charges":[{"minimum":1562,"maximum":2264.95,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2264.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2264.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2264.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1562,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED OVA CA RLTD DO PNL 17","code_information":[{"code":"0132U","type":"CPT"}],"standard_charges":[{"minimum":1631.61,"maximum":2088.43,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2088.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2088.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2088.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1631.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED PRST8 CA RLTD DO 11","code_information":[{"code":"0133U","type":"CPT"}],"standard_charges":[{"minimum":1318.47,"maximum":1518.64,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1318.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1318.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1318.47,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1518.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0134A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED PAN CA MRNA PNL 18 GEN","code_information":[{"code":"0134U","type":"CPT"}],"standard_charges":[{"minimum":1646.46,"maximum":2107.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2107.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2107.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2107.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1646.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED GYN CA MRNA PNL 12 GEN","code_information":[{"code":"0135U","type":"CPT"}],"standard_charges":[{"minimum":1541.23,"maximum":2234.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2234.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2234.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2234.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1541.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ATM MRNA SEQ ALYS","code_information":[{"code":"0136U","type":"CPT"}],"standard_charges":[{"minimum":896.35,"maximum":1299.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1299.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1299.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1299.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":896.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PALB2 MRNA SEQ ALYS","code_information":[{"code":"0137U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":902.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":902.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":902.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":902.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BRCA1 BRCA2 MRNA SEQ ALYS","code_information":[{"code":"0138U","type":"CPT"}],"standard_charges":[{"minimum":1030.33,"maximum":1494,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1494,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1494,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1494,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1030.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEURO AUSTM MEAS 6 C METABLT","code_information":[{"code":"0139U","type":"CPT"}],"standard_charges":[{"minimum":1650,"maximum":1650,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1650,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"014","type":"MS-DRG"}],"standard_charges":[{"minimum":114719.56,"maximum":225619,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":206240.13,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":154684.95,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":154684.95,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":162710.4,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":162710.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":167191.61,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":198537,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":163914,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":225619,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":114719.56,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":115866.76,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":118161.15,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":117013.96,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":114719.56,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":114719.56,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":114719.56,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":115866.76,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":114719.56,"methodology":"case rate"}]}]},{"description":"NFCT DS FUNGI DNA 15 TRGT","code_information":[{"code":"0140U","type":"CPT"}],"standard_charges":[{"minimum":98.82,"maximum":344.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":344.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ADM SARSCV2 VAC 25MCG 1ST DOSE","code_information":[{"code":"0141A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"ADM SARSCV2 VAC 25MCG 1ST DOSE","code_information":[{"code":"0141A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"NFCT DS BACTFNG GRAM POS","code_information":[{"code":"0141U","type":"CPT"}],"standard_charges":[{"minimum":344.85,"maximum":1002.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":344.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ADM SARSCV2 VAC25MCG 2ND DOSE","code_information":[{"code":"0142A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"ADM SARSCV2 VAC25MCG 2ND DOSE","code_information":[{"code":"0142A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"NFCT DS BACTFNG GRAM NEG","code_information":[{"code":"0142U","type":"CPT"}],"standard_charges":[{"minimum":344.85,"maximum":1002.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1002.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":344.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 120+ RX/METABLT","code_information":[{"code":"0143U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0144A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 160+ RX/METABLT","code_information":[{"code":"0144U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 65+ RX/METABLT","code_information":[{"code":"0145U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 80+ RX/METABLT","code_information":[{"code":"0146U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 85+ RX/METABLT","code_information":[{"code":"0147U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 100+ RX/METABLT","code_information":[{"code":"0148U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 60+ RX/METABLT","code_information":[{"code":"0149U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DRUG ASSAY 120+ RX/METABLT","code_information":[{"code":"0150U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":251.75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NFCT BCT/VIR RESP NFCTJ 33","code_information":[{"code":"0151U","type":"CPT"}],"standard_charges":[{"minimum":420.42,"maximum":420.42,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":420.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NFCT BCT FNG PRST DNA >1000","code_information":[{"code":"0152U","type":"CPT"}],"standard_charges":[{"minimum":563.18,"maximum":4677.64,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":563.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":563.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":563.18,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4677.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BREAST MRNA 101 GENES","code_information":[{"code":"0153U","type":"CPT"}],"standard_charges":[{"minimum":6950.72,"maximum":11380.54,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11380.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11380.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11380.54,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6950.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0154A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC URTHL CA RNA FGFR3 GENE","code_information":[{"code":"0154U","type":"CPT"}],"standard_charges":[{"minimum":1060.71,"maximum":11435.7,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11435.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11435.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11435.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1060.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BRST CA DNA PIK3CA GENE","code_information":[{"code":"0155U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":11380.54,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11380.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11380.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11380.54,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"COPY NUMBER SEQUENCE ALYS","code_information":[{"code":"0156U","type":"CPT"}],"standard_charges":[{"minimum":2871.07,"maximum":3828,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2871.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2871.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2871.07,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3828,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"APC MRNA SEQ ALYS","code_information":[{"code":"0157U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":1865.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MLH1 MRNA SEQ ALYS","code_information":[{"code":"0158U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":1865.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MSH2 MRNA SEQ ALYS","code_information":[{"code":"0159U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":1865.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC","code_information":[{"code":"016","type":"MS-DRG"}],"standard_charges":[{"minimum":76061.09,"maximum":156213.04,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156213.04,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":117163.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":117163.45,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87694.87,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":87694.87,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":90110.08,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107004,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":88343,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":121600,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":76821.71,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":78342.93,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":77582.32,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":76821.71,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"}]}]},{"description":"MSH6 MRNA SEQ ALYS","code_information":[{"code":"0160U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":1865.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PMS2 MRNA SEQ ALYS","code_information":[{"code":"0161U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":1865.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HERED COLON CA TRGT MRNA PNL","code_information":[{"code":"0162U","type":"CPT"}],"standard_charges":[{"minimum":1070.39,"maximum":1865.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1070.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LUMB ARTIF DISKECTOMY ADDL","code_information":[{"code":"0163T","type":"CPT"}],"standard_charges":[{"minimum":2513.63,"maximum":2513.63,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2513.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC CLRCT SCR 3 PRTN ALG","code_information":[{"code":"0163U","type":"CPT"}],"standard_charges":[{"minimum":859.65,"maximum":1360.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1360.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1360.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1360.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":859.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0164A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REMOVE LUMB ARTIF DISC ADDL","code_information":[{"code":"0164T","type":"CPT"}],"standard_charges":[{"minimum":2149.44,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2149.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GI IBS IA ANTI-CDTBVINCULIN","code_information":[{"code":"0164U","type":"CPT"}],"standard_charges":[{"minimum":48.63,"maximum":246.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":48.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":48.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":246.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REVISE LUMB ARTIF DISC ADDL","code_information":[{"code":"0165T","type":"CPT"}],"standard_charges":[{"minimum":1957.89,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1957.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PEANUT ALLG ASMT EPI","code_information":[{"code":"0165U","type":"CPT"}],"standard_charges":[{"minimum":14.71,"maximum":1020.27,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14.71,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1020.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LIVER DS 10 BIOCHEM ASY SRM","code_information":[{"code":"0166U","type":"CPT"}],"standard_charges":[{"minimum":1107.48,"maximum":1417.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1417.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1417.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1417.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1107.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CHORNC GONADOTROPIN HCG IA","code_information":[{"code":"0167U","type":"CPT"}],"standard_charges":[{"minimum":16.54,"maximum":21.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FTL ANEUPLOIDY DNA SEQ ALYS","code_information":[{"code":"0168U","type":"CPT"}],"standard_charges":[{"minimum":1669.91,"maximum":1669.91,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1669.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NUDT15TPMT GENE COM VRNT","code_information":[{"code":"0169U","type":"CPT"}],"standard_charges":[{"minimum":929.44,"maximum":1025.57,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":929.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":929.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":929.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1025.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC","code_information":[{"code":"017","type":"MS-DRG"}],"standard_charges":[{"minimum":76061.09,"maximum":121600,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":106961.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":80223.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":80223.41,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87694.87,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":87694.87,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":90110.08,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107004,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":88343,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":121600,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":76821.71,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":78342.93,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":77582.32,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":76821.71,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":76061.09,"methodology":"case rate"}]}]},{"description":"NEURO ASD RNA NEXT GEN SEQ","code_information":[{"code":"0170U","type":"CPT"}],"standard_charges":[{"minimum":2871.26,"maximum":3861,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2871.26,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2871.26,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2871.26,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3861,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ADM SARSCV2 VAC 3MCG TSF 1DOSE","code_information":[{"code":"0171A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"ADM SARSCV2 VAC 3MCG TSF 1DOSE","code_information":[{"code":"0171A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"TRGT GEN SEQ ALYS PNL DNA 23","code_information":[{"code":"0171U","type":"CPT"}],"standard_charges":[{"minimum":786.42,"maximum":3341.93,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":786.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":786.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":786.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3341.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ADM SARSCV2 VAC 3MCG TSF 2DOSE","code_information":[{"code":"0172A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"ADM SARSCV2 VAC 3MCG TSF 2DOSE","code_information":[{"code":"0172A","type":"CPT"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":87.98,"maximum":135.622,"gross_charge":166,"discounted_cash":66.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.63,"methodology":"fee schedule"}]}]},{"description":"ONC SLD TUM ALYS BRCA1 BRCA2","code_information":[{"code":"0172U","type":"CPT"}],"standard_charges":[{"minimum":5821.53,"maximum":6666,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5821.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5821.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5821.53,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6666,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0173A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PSYC GEN ALYS PANEL 14 GENES","code_information":[{"code":"0173U","type":"CPT"}],"standard_charges":[{"minimum":1025.57,"maximum":1438.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1025.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0174A","type":"CPT"}],"standard_charges":[{"minimum":89.25,"maximum":89.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":89.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CAD CXR WITH INTERP","code_information":[{"code":"0174T","type":"CPT"}],"standard_charges":[{"minimum":29.99,"maximum":67.21,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":29.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":29.99,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":67.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC SOLID TUMOR 30 PRTN TRGT","code_information":[{"code":"0174U","type":"CPT"}],"standard_charges":[{"minimum":2871.81,"maximum":8084.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8084.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2871.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CAD CXR REMOTE","code_information":[{"code":"0175T","type":"CPT"}],"standard_charges":[{"minimum":32.47,"maximum":32.47,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":32.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PSYC GEN ALYS PANEL 15 GENES","code_information":[{"code":"0175U","type":"CPT"}],"standard_charges":[{"minimum":1438.46,"maximum":2939.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1438.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2939.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CDTBVINCULIN IGG ANTB IA","code_information":[{"code":"0176U","type":"CPT"}],"standard_charges":[{"minimum":141.22,"maximum":180.76,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.76,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":180.76,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":180.76,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":141.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BRST CA DNA PIK3CA 11","code_information":[{"code":"0177U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":876.73,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PEANUT ALLG ASMT EPI CLIN RX","code_information":[{"code":"0178U","type":"CPT"}],"standard_charges":[{"minimum":1011.69,"maximum":1305.94,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1305.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1305.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1305.94,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1011.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC NONSM CLL LNG CA ALYS 23","code_information":[{"code":"0179U","type":"CPT"}],"standard_charges":[{"minimum":2173.35,"maximum":4275.06,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4275.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES","code_information":[{"code":"018","type":"MS-DRG"}],"standard_charges":[{"minimum":117163.45,"maximum":725285,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156213.04,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":117163.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":117163.45,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":523055.81,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":523055.81,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":537461.31,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":638226,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":526924,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":725285,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":300419.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":303424,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":309432.4,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":306428.2,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":300419.8,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":300419.8,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":300419.8,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":303424,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":300419.8,"methodology":"case rate"}]}]},{"description":"ABO GNOTYP ABO 7 EXONS","code_information":[{"code":"0180U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CO GNOTYP AQP1 EXON 1","code_information":[{"code":"0181U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CROM GNOTYP CD55 EXONS 1-10","code_information":[{"code":"0182U","type":"CPT"}],"standard_charges":[{"minimum":662.97,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":662.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DI GNOTYP SLC4A1 EXON 19","code_information":[{"code":"0183U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXC RECTAL TUMOR ENDOSCOPIC","code_information":[{"code":"0184T","type":"CPT"}],"standard_charges":[{"minimum":1747.72,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1747.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DO GNOTYP ART4 EXON 2","code_information":[{"code":"0184U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FUT1 GNOTYP FUT1 EXON 4","code_information":[{"code":"0185U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FUT2 GNOTYP FUT2 EXON 2","code_information":[{"code":"0186U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FY GNOTYP ACKR1 EXONS 1-2","code_information":[{"code":"0187U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":6178.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6178.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":6178.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":6178.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GE GNOTYP GYPC EXONS 1-4","code_information":[{"code":"0188U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GYPA GNOTYP NTRNS 1 5 EXON 2","code_information":[{"code":"0189U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS","code_information":[{"code":"019","type":"MS-DRG"}],"standard_charges":[{"minimum":89351.1,"maximum":198991.77,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":198991.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":149248.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":149248.51,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":113483.72,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":113483.72,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":116609.18,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":138471,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":114323,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":157360,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":89351.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":90244.62,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":92031.64,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":91138.13,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":89351.1,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":89351.1,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":89351.1,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":90244.62,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":89351.1,"methodology":"case rate"}]}]},{"description":"GYPB GNOTYP NTRNS 1 5 SEUX 3","code_information":[{"code":"0190U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ANT SEGMENT DRAIN INT","code_information":[{"code":"0191T","type":"CPT"}],"standard_charges":[{"minimum":705.94,"maximum":705.94,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":705.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IN GNOTYP CD44 EXONS 2 3 6","code_information":[{"code":"0191U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"JK GNOTYP SLC14A1 EXON 9","code_information":[{"code":"0192U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"JR GNOTYP ABCG2 EXONS 2-26","code_information":[{"code":"0193U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"KEL GNOTYP KEL EXON 8","code_information":[{"code":"0194U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"KLF1 TARGETED SEQUENCING","code_information":[{"code":"0195U","type":"CPT"}],"standard_charges":[{"minimum":825.55,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":825.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LU GNOTYP BCAM EXON 3","code_information":[{"code":"0196U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LW GNOTYP ICAM4 EXON 1","code_information":[{"code":"0197U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":590.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":590.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OCULAR BLOOD FLOW MEASURE","code_information":[{"code":"0198T","type":"CPT"}],"standard_charges":[{"minimum":1325.7,"maximum":1325.7,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1325.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RHDRHCE GNTYP RHD1-10RHCE5","code_information":[{"code":"0198U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOSP MANAGE CONT DRUG ADMIN","code_information":[{"code":"01996","type":"CPT"}],"standard_charges":[{"minimum":137.35,"maximum":137.35,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":137.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SC GNOTYP ERMAP EXONS 4 12","code_information":[{"code":"0199U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC","code_information":[{"code":"020","type":"MS-DRG"}],"standard_charges":[{"minimum":92708.54,"maximum":216997.83,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":195556,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":195556,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":216997.83,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":162753.47,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":162753.47,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":119998.72,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":119998.72,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":142668.06,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":162912,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":186570,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":120886,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":92708.54,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":93635.63,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":95489.8,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":94562.72,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":92708.54,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":92708.54,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":92708.54,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":93635.63,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":92708.54,"methodology":"case rate"}]}]},{"description":"PERQ SACRAL AUGMT UNILAT INJ","code_information":[{"code":"0200T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4628.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"XK GNOTYP XK EXONS 1-3","code_information":[{"code":"0200U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0201","type":"APR-DRG"}],"standard_charges":[{"minimum":14215,"maximum":14215,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14215,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14215,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14215,"methodology":"case rate"}]}]},{"description":"PERQ SACRAL AUGMT BILAT INJ","code_information":[{"code":"0201T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3135.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"YT GNOTYP ACHE EXON 2","code_information":[{"code":"0201U","type":"CPT"}],"standard_charges":[{"minimum":407.44,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0202","type":"APR-DRG"}],"standard_charges":[{"minimum":17830,"maximum":17830,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17830,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17830,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17830,"methodology":"case rate"}]}]},{"description":"POST VERT ARTHRPLST 1 LUMBAR","code_information":[{"code":"0202T","type":"CPT"}],"standard_charges":[{"minimum":4695.7,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4695.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NFCT DS 22 TRGT SARS-COV-2","code_information":[{"code":"0202U","type":"CPT"}],"standard_charges":[{"minimum":401.63,"maximum":916.92,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":401.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":916.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0203","type":"APR-DRG"}],"standard_charges":[{"minimum":23058,"maximum":23058,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":23058,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":23058,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":23058,"methodology":"case rate"}]}]},{"description":"AI IBD MRNA XPRSN PRFL 17","code_information":[{"code":"0203U","type":"CPT"}],"standard_charges":[{"minimum":1672,"maximum":2112,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2112,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2112,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2112,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0204","type":"APR-DRG"}],"standard_charges":[{"minimum":38140,"maximum":38140,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38140,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38140,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38140,"methodology":"case rate"}]}]},{"description":"ONC THYR MRNA XPRSN ALYS 593","code_information":[{"code":"0204U","type":"CPT"}],"standard_charges":[{"minimum":6423.12,"maximum":7241.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7241.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7241.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7241.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6423.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPH AMD ALYS 3 GENE VARIANTS","code_information":[{"code":"0205U","type":"CPT"}],"standard_charges":[{"minimum":103.4,"maximum":312.17,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":103.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEURO ALZHEIMER CELL AGGREGJ","code_information":[{"code":"0206U","type":"CPT"}],"standard_charges":[{"minimum":312.17,"maximum":4873.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4873.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLEAR EYELID GLAND W/HEAT","code_information":[{"code":"0207T","type":"CPT"}],"standard_charges":[{"minimum":143.84,"maximum":886.51,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":886.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":886.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":886.51,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":143.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEURO ALZHEIMER QUAN IMAGING","code_information":[{"code":"0207U","type":"CPT"}],"standard_charges":[{"minimum":156.09,"maximum":1124.64,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156.09,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":156.09,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":156.09,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1124.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUDIOMETRY AIR ONLY","code_information":[{"code":"0208T","type":"CPT"}],"standard_charges":[{"minimum":69.5,"maximum":100.39,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":100.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":100.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":100.39,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":69.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUDIOMETRY AIR  BONE","code_information":[{"code":"0209T","type":"CPT"}],"standard_charges":[{"minimum":90.49,"maximum":134.27,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":134.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":134.27,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":90.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYTOG CONST ALYS INTERROG","code_information":[{"code":"0209U","type":"CPT"}],"standard_charges":[{"minimum":686.68,"maximum":1731.73,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":686.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":686.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":686.68,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1731.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC","code_information":[{"code":"021","type":"MS-DRG"}],"standard_charges":[{"minimum":75800.63,"maximum":188693.48,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148034,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":148034,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188693.48,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":141524.55,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":141524.55,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87189.46,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":87189.46,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":103660.69,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":118369,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":135559,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":87834,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":75800.63,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":76558.64,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":78074.65,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":77316.65,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":75800.63,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":75800.63,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":75800.63,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":76558.64,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":75800.63,"methodology":"case rate"}]}]},{"description":"SPEECH AUDIOMETRY THRESHOLD","code_information":[{"code":"0210T","type":"CPT"}],"standard_charges":[{"minimum":54.23,"maximum":74.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":74.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":74.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":74.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":54.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SYPHILIS TST ANTB IA QUAN","code_information":[{"code":"0210U","type":"CPT"}],"standard_charges":[{"minimum":17.46,"maximum":40.99,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":17.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":17.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":40.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0211","type":"APR-DRG"}],"standard_charges":[{"minimum":12843,"maximum":12843,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12843,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12843,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12843,"methodology":"case rate"}]}]},{"description":"SPEECH AUDIOM THRESH  RECOG","code_information":[{"code":"0211T","type":"CPT"}],"standard_charges":[{"minimum":82.48,"maximum":115.36,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":115.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":115.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":115.36,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":82.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC PAN-TUM DNARNA GNRJ SEQ","code_information":[{"code":"0211U","type":"CPT"}],"standard_charges":[{"minimum":1362.44,"maximum":18601,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":18601,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0212","type":"APR-DRG"}],"standard_charges":[{"minimum":16801,"maximum":16801,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16801,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16801,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16801,"methodology":"case rate"}]}]},{"description":"COMPRE AUDIOMETRY EVALUATION","code_information":[{"code":"0212T","type":"CPT"}],"standard_charges":[{"minimum":84.68,"maximum":204.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":204.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":204.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":204.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":84.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RARE DS GEN DNA ALYS PROBAND","code_information":[{"code":"0212U","type":"CPT"}],"standard_charges":[{"minimum":11464.24,"maximum":12045.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12045.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0213","type":"APR-DRG"}],"standard_charges":[{"minimum":26059,"maximum":26059,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26059,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26059,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26059,"methodology":"case rate"}]}]},{"description":"NJX PARAVERT W/US CER/THOR","code_information":[{"code":"0213T","type":"CPT"}],"standard_charges":[{"minimum":254.23,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1809.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1809.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1809.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":254.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RARE DS GEN DNA ALYS EA COMP","code_information":[{"code":"0213U","type":"CPT"}],"standard_charges":[{"minimum":5961.89,"maximum":6174.99,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6174.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":6174.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":6174.99,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5961.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0214","type":"APR-DRG"}],"standard_charges":[{"minimum":42642,"maximum":42642,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":42642,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":42642,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":42642,"methodology":"case rate"}]}]},{"description":"NJX PARAVERT W/US CER/THOR","code_information":[{"code":"0214T","type":"CPT"}],"standard_charges":[{"minimum":144.83,"maximum":921.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":144.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RARE DS XOM DNA ALYS PROBAND","code_information":[{"code":"0214U","type":"CPT"}],"standard_charges":[{"minimum":10891.85,"maximum":11494.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10891.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10891.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10891.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11494.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NJX PARAVERT W/US CER/THOR","code_information":[{"code":"0215T","type":"CPT"}],"standard_charges":[{"minimum":147.38,"maximum":921.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":147.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RARE DS XOM DNA ALYS EA COMP","code_information":[{"code":"0215U","type":"CPT"}],"standard_charges":[{"minimum":5664.23,"maximum":27343.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27343.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":27343.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":27343.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5664.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NJX PARAVERT W/US LUMB/SAC","code_information":[{"code":"0216T","type":"CPT"}],"standard_charges":[{"minimum":214.59,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1809.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1809.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1809.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":214.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEURO INH ATAXIA DNA 12 COM","code_information":[{"code":"0216U","type":"CPT"}],"standard_charges":[{"minimum":2932.61,"maximum":3381.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2932.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2932.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2932.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3381.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NJX PARAVERT W/US LUMB/SAC","code_information":[{"code":"0217T","type":"CPT"}],"standard_charges":[{"minimum":123.68,"maximum":627.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":123.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEURO INH ATAXIA DNA 51 GENE","code_information":[{"code":"0217U","type":"CPT"}],"standard_charges":[{"minimum":2932.61,"maximum":4836.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2932.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2932.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2932.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4836.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NJX PARAVERT W/US LUMB/SAC","code_information":[{"code":"0218T","type":"CPT"}],"standard_charges":[{"minimum":126.19,"maximum":627.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":126.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEURO MUSC DYS DMD SEQ ALYS","code_information":[{"code":"0218U","type":"CPT"}],"standard_charges":[{"minimum":635.76,"maximum":5013.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":635.76,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":635.76,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":635.76,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5013.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PLMT POST FACET IMPLT CERV","code_information":[{"code":"0219T","type":"CPT"}],"standard_charges":[{"minimum":2290.4,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2290.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NFCT AGT HIV GNRJ SEQ ALYS","code_information":[{"code":"0219U","type":"CPT"}],"standard_charges":[{"minimum":517.84,"maximum":1595,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":517.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":517.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":517.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1595,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC","code_information":[{"code":"022","type":"MS-DRG"}],"standard_charges":[{"minimum":55690.57,"maximum":157907.09,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":95439,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":95439,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":157907.09,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":118434.03,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":118434.03,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55690.57,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":55690.57,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":66211.25,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":75606,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":86586,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":56102,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":59568.01,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":60163.7,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":61355.06,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":60759.38,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":59568.01,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":59568.01,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":59568.01,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":60163.7,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":59568.01,"methodology":"case rate"}]}]},{"description":"PLMT POST FACET IMPLT THOR","code_information":[{"code":"0220T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":2837.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2837.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC BRST CA AI ASSMT 12 FEAT","code_information":[{"code":"0220U","type":"CPT"}],"standard_charges":[{"minimum":1553.75,"maximum":6500.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6500.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":6500.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":6500.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1553.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0221","type":"APR-DRG"}],"standard_charges":[{"minimum":8226,"maximum":8226,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8226,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8226,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8226,"methodology":"case rate"}]}]},{"description":"PLMT POST FACET IMPLT LUMB","code_information":[{"code":"0221T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2719.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ABO GNOTYP NEXT GNRJ SEQ ABO","code_information":[{"code":"0221U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":626.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":626.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":626.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":626.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0222","type":"APR-DRG"}],"standard_charges":[{"minimum":10531,"maximum":10531,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10531,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10531,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10531,"methodology":"case rate"}]}]},{"description":"PLMT POST FACET IMPLT ADDL","code_information":[{"code":"0222T","type":"CPT"}],"standard_charges":[{"minimum":789.95,"maximum":1319.81,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1319.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1319.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1319.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":789.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RHDRHCE GNTYP NEXT GNRJ SEQ","code_information":[{"code":"0222U","type":"CPT"}],"standard_charges":[{"minimum":622.34,"maximum":644.59,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":644.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":644.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":644.59,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":622.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0223","type":"APR-DRG"}],"standard_charges":[{"minimum":17268,"maximum":17268,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17268,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17268,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17268,"methodology":"case rate"}]}]},{"description":"NFCT DS 22 TRGT SARS-COV-2","code_information":[{"code":"0223U","type":"CPT"}],"standard_charges":[{"minimum":200.55,"maximum":916.92,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":200.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":200.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":200.55,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":916.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0224","type":"APR-DRG"}],"standard_charges":[{"minimum":38104,"maximum":38104,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38104,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38104,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38104,"methodology":"case rate"}]}]},{"description":"ANTIBODY SARS-COV-2 TITER(S)","code_information":[{"code":"0224U","type":"CPT"}],"standard_charges":[{"minimum":80.49,"maximum":113.15,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":80.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":80.49,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":113.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NFCT DS DNARNA 21 SARSCOV2","code_information":[{"code":"0225U","type":"CPT"}],"standard_charges":[{"minimum":144.47,"maximum":916.92,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":144.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":144.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":144.47,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":916.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SVNT SARSCOV2 ELISA PLSM SRM","code_information":[{"code":"0226U","type":"CPT"}],"standard_charges":[{"minimum":34.04,"maximum":93.02,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":34.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":34.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":93.02,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RX ASY PRSMV 30+RX/METABLT","code_information":[{"code":"0227U","type":"CPT"}],"standard_charges":[{"minimum":136.71,"maximum":174.99,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":174.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":174.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":174.99,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":136.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NJX TFRML EPRL W/US CER/THOR","code_information":[{"code":"0228T","type":"CPT"}],"standard_charges":[{"minimum":131.25,"maximum":131.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":131.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC PRST8 MA MOLEC PRFL ALG","code_information":[{"code":"0228U","type":"CPT"}],"standard_charges":[{"minimum":380.67,"maximum":2140.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":380.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NJX TFRML EPRL W/US CER/THOR","code_information":[{"code":"0229T","type":"CPT"}],"standard_charges":[{"minimum":131.25,"maximum":131.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":131.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BCAT1 PROMOTER MTHYLTN ALYS","code_information":[{"code":"0229U","type":"CPT"}],"standard_charges":[{"minimum":613.53,"maximum":844.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":613.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":613.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":613.53,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":844.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR","code_information":[{"code":"023","type":"MS-DRG"}],"standard_charges":[{"minimum":72342.96,"maximum":125127,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":113820.33,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":85367.93,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":85367.93,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80479.95,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":80479.95,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":82696.45,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109260,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":125127,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":81075,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":72342.96,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":73066.39,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":74513.25,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":73789.82,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":72342.96,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":72342.96,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":72342.96,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":73066.39,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":72342.96,"methodology":"case rate"}]}]},{"description":"NJX TFRML EPRL W/US LUMB/SAC","code_information":[{"code":"0230T","type":"CPT"}],"standard_charges":[{"minimum":131.25,"maximum":131.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":131.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AR FULL SEQUENCE ANALYSIS","code_information":[{"code":"0230U","type":"CPT"}],"standard_charges":[{"minimum":662.97,"maximum":961.34,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":961.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":961.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":961.34,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":662.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0231","type":"APR-DRG"}],"standard_charges":[{"minimum":10034,"maximum":10034,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10034,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10034,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10034,"methodology":"case rate"}]}]},{"description":"NJX TFRML EPRL W/US LUMB/SAC","code_information":[{"code":"0231T","type":"CPT"}],"standard_charges":[{"minimum":131.25,"maximum":131.25,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":131.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CACNA1A FULL GENE ANALYSIS","code_information":[{"code":"0231U","type":"CPT"}],"standard_charges":[{"minimum":1861.79,"maximum":2699.67,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2699.67,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2699.67,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2699.67,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1861.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0232","type":"APR-DRG"}],"standard_charges":[{"minimum":13767,"maximum":13767,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13767,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13767,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13767,"methodology":"case rate"}]}]},{"description":"NJX PLATELET PLASMA","code_information":[{"code":"0232T","type":"CPT"}],"standard_charges":[{"minimum":161.11,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":161.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CSTB FULL GENE ANALYSIS","code_information":[{"code":"0232U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":876.73,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0233","type":"APR-DRG"}],"standard_charges":[{"minimum":24506,"maximum":24506,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24506,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24506,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24506,"methodology":"case rate"}]}]},{"description":"FXN GENE ANALYSIS","code_information":[{"code":"0233U","type":"CPT"}],"standard_charges":[{"minimum":604.63,"maximum":876.73,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":876.73,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":604.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0234","type":"APR-DRG"}],"standard_charges":[{"minimum":38597,"maximum":38597,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38597,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38597,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38597,"methodology":"case rate"}]}]},{"description":"TRLUML PERIP ATHRC RENAL ART","code_information":[{"code":"0234T","type":"CPT"}],"standard_charges":[{"minimum":5030.3,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5030.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MECP2 FULL GENE ANALYSIS","code_information":[{"code":"0234U","type":"CPT"}],"standard_charges":[{"minimum":1161.31,"maximum":1683.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1683.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1683.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1683.97,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1161.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRLUML PERIP ATHRC VISCERAL","code_information":[{"code":"0235T","type":"CPT"}],"standard_charges":[{"minimum":4639.36,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4639.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PTEN FULL GENE ANALYSIS","code_information":[{"code":"0235U","type":"CPT"}],"standard_charges":[{"minimum":1320,"maximum":1914.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1914.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1914.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1914.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1320,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRLUML PERIP ATHRC ABD AORTA","code_information":[{"code":"0236T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":11684,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11684,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SMN1SMN2 FULL GENE ANALYSIS","code_information":[{"code":"0236U","type":"CPT"}],"standard_charges":[{"minimum":961.34,"maximum":1325.94,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":961.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":961.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":961.34,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1325.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRLUML PERIP ATHRC BRCHIOCPH","code_information":[{"code":"0237T","type":"CPT"}],"standard_charges":[{"minimum":1294.24,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1294.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CAR ION CHNLPTHY GEN SEQ PNL","code_information":[{"code":"0237U","type":"CPT"}],"standard_charges":[{"minimum":1286.78,"maximum":1865.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1865.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1286.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRLUML PERIP ATHRC ILIAC ART","code_information":[{"code":"0238T","type":"CPT"}],"standard_charges":[{"minimum":1634.67,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1634.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONC LNCH SYN GEN DNA SEQ ALY","code_information":[{"code":"0238U","type":"CPT"}],"standard_charges":[{"minimum":645.66,"maximum":1286.78,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":645.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":645.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":645.66,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1286.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRGT GEN SEQ ALYS PNL 311+","code_information":[{"code":"0239U","type":"CPT"}],"standard_charges":[{"minimum":1907.4,"maximum":7700,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1907.4,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1907.4,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1907.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7700,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC","code_information":[{"code":"024","type":"MS-DRG"}],"standard_charges":[{"minimum":53789.59,"maximum":94321.22,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":94321.22,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":70743.13,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":70743.13,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53789.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":53789.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":55271.01,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73025,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":83630,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":54187,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":58588.36,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":59174.25,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":60346.02,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":59760.13,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":58588.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":58588.36,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":58588.36,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":59174.25,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":58588.36,"methodology":"case rate"}]}]},{"description":"NFCT DS VIR RESP RNA 3 TRGT","code_information":[{"code":"0240U","type":"CPT"}],"standard_charges":[{"minimum":286.88,"maximum":313.79,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":286.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":286.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":286.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":313.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0241","type":"APR-DRG"}],"standard_charges":[{"minimum":5831,"maximum":5831,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5831,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5831,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5831,"methodology":"case rate"}]}]},{"description":"CP RESP VIRUS RNA 4 TARGETS","code_information":[{"code":"0241U","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":318,"maximum":490.2,"gross_charge":600,"discounted_cash":240,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":318,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"}]}]},{"description":"CP RESP VIRUS RNA 4 TARGETS","code_information":[{"code":"0241U","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":142.63,"maximum":490.2,"gross_charge":600,"discounted_cash":240,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":318,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":144.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":146.91,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":145.49,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":144.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"methodology":"fee schedule"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0242","type":"APR-DRG"}],"standard_charges":[{"minimum":7978,"maximum":7978,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7978,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7978,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7978,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0242U","type":"CPT"}],"standard_charges":[{"minimum":10057.11,"maximum":11000,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10057.11,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10057.11,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10057.11,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11000,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0243","type":"APR-DRG"}],"standard_charges":[{"minimum":14664,"maximum":14664,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14664,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14664,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14664,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0243U","type":"CPT"}],"standard_charges":[{"minimum":68.07,"maximum":141.7,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":68.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":68.07,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":141.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0244","type":"APR-DRG"}],"standard_charges":[{"minimum":26793,"maximum":26793,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26793,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26793,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26793,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0244U","type":"CPT"}],"standard_charges":[{"minimum":7700,"maximum":7975.21,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7975.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7975.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7975.21,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7700,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0245U","type":"CPT"}],"standard_charges":[{"minimum":2785.35,"maximum":8453.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8453.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8453.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8453.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2785.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0246U","type":"CPT"}],"standard_charges":[{"minimum":1584,"maximum":2296.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2296.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1584,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0247U","type":"CPT"}],"standard_charges":[{"minimum":61.2,"maximum":1650,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":61.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":61.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":61.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1650,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0248U","type":"CPT"}],"standard_charges":[{"minimum":1454.69,"maximum":6674.49,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1454.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1454.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1454.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6674.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0249U","type":"CPT"}],"standard_charges":[{"minimum":4882.09,"maximum":5647.18,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5647.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5647.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5647.18,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4882.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC","code_information":[{"code":"025","type":"MS-DRG"}],"standard_charges":[{"minimum":62693.95,"maximum":126138.08,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107921,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":107921,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126138.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":94606.53,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":94606.53,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":62693.95,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":62693.95,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":74537.66,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":85114,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":97474,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":63158,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":63177.13,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":63808.91,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":65072.45,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":64440.68,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":63177.13,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":63177.13,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":63177.13,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":63808.91,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":63177.13,"methodology":"case rate"}]}]},{"description":"PHARMACY - GENERAL","code_information":[{"code":"0250","type":"RC"}],"standard_charges":[{"minimum":76.4,"maximum":76.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0250U","type":"CPT"}],"standard_charges":[{"minimum":6423.12,"maximum":11803.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11803.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11803.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11803.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6423.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - GENERIC DRUGS","code_information":[{"code":"0251","type":"RC"}],"standard_charges":[{"minimum":76.4,"maximum":76.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0251U","type":"CPT"}],"standard_charges":[{"minimum":37.99,"maximum":38.01,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":38.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":38.01,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - NON-GENERIC DRUGS","code_information":[{"code":"0252","type":"RC"}],"standard_charges":[{"minimum":76.4,"maximum":76.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0252U","type":"CPT"}],"standard_charges":[{"minimum":161.62,"maximum":1669.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":161.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":161.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1669.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - TAKE HOME DRUGS","code_information":[{"code":"0253","type":"RC"}],"standard_charges":[{"minimum":19.1,"maximum":19.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT AQUEOUS DRAIN DEVICE","code_information":[{"code":"0253T","type":"CPT"}],"standard_charges":[{"minimum":1999.89,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1999.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0253U","type":"CPT"}],"standard_charges":[{"minimum":6950.72,"maximum":9845.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9845.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9845.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9845.97,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6950.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - DRUGS INCIDENT TO OTHER DIAGNOSTIC SERVICES","code_information":[{"code":"0254","type":"RC"}],"standard_charges":[{"minimum":19.1,"maximum":19.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0254U","type":"CPT"}],"standard_charges":[{"minimum":1450.22,"maximum":1669.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1450.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1450.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1450.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1669.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - DRUGS INCIDENT TO RADIOLOGY","code_information":[{"code":"0255","type":"RC"}],"standard_charges":[{"minimum":19.1,"maximum":19.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0255U","type":"CPT"}],"standard_charges":[{"minimum":69.52,"maximum":327.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":327.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":327.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":327.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":69.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - EXPERIMENTAL DRUGS","code_information":[{"code":"0256","type":"RC"}],"standard_charges":[{"minimum":19.1,"maximum":19.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0256U","type":"CPT"}],"standard_charges":[{"minimum":71.78,"maximum":351.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":71.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":71.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":71.78,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":351.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - NON-PRESCRIPTION","code_information":[{"code":"0257","type":"RC"}],"standard_charges":[{"minimum":19.1,"maximum":19.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0257U","type":"CPT"}],"standard_charges":[{"minimum":66.01,"maximum":1567.43,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":66.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":66.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":66.01,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1567.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - IV SOLUTIONS","code_information":[{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":76.4,"maximum":76.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":76.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0258U","type":"CPT"}],"standard_charges":[{"minimum":2502.52,"maximum":8085,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2502.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2502.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2502.52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":8085,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHARMACY - OTHER","code_information":[{"code":"0259","type":"RC"}],"standard_charges":[{"minimum":19.1,"maximum":19.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0259U","type":"CPT"}],"standard_charges":[{"minimum":55.12,"maximum":115.96,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":55.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":55.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":115.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC","code_information":[{"code":"026","type":"MS-DRG"}],"standard_charges":[{"minimum":41925.16,"maximum":94037.28,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68463,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":68463,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":94037.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":70530.17,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":70530.17,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41925.16,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":41925.16,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":49845.37,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56918,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":65184,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":42235,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":52474.15,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":52998.9,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":54048.38,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":53523.64,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":52474.15,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":52474.15,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":52474.15,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":52998.9,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":52474.15,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0260U","type":"CPT"}],"standard_charges":[{"minimum":192.38,"maximum":2779.77,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":192.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":192.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":192.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2779.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0261","type":"APR-DRG"}],"standard_charges":[{"minimum":8541,"maximum":8541,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8541,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8541,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8541,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0261U","type":"CPT"}],"standard_charges":[{"minimum":2166.97,"maximum":10890,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2166.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2166.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2166.97,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10890,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0262","type":"APR-DRG"}],"standard_charges":[{"minimum":10772,"maximum":10772,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10772,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10772,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10772,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0262U","type":"CPT"}],"standard_charges":[{"minimum":7040,"maximum":8311.67,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8311.67,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8311.67,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8311.67,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7040,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0263","type":"APR-DRG"}],"standard_charges":[{"minimum":16177,"maximum":16177,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16177,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16177,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16177,"methodology":"case rate"}]}]},{"description":"IM B1 MRW CEL THER CMPL","code_information":[{"code":"0263T","type":"CPT"}],"standard_charges":[{"minimum":135.85,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":135.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0263U","type":"CPT"}],"standard_charges":[{"minimum":1650,"maximum":2232.68,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2232.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2232.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2232.68,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1650,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IV THERAPY - SUPPLIES","code_information":[{"code":"0264","type":"RC"}],"standard_charges":[{"minimum":328.02,"maximum":328.02,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":328.02,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":328.02,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":328.02,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0264","type":"APR-DRG"}],"standard_charges":[{"minimum":32576,"maximum":32576,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":32576,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":32576,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":32576,"methodology":"case rate"}]}]},{"description":"IM B1 MRW CEL THER XCL HRVST","code_information":[{"code":"0264T","type":"CPT"}],"standard_charges":[{"minimum":356.29,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":356.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0264U","type":"CPT"}],"standard_charges":[{"minimum":8.79,"maximum":2779.77,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8.79,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2779.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IM B1 MRW CEL THER HRVST ONL","code_information":[{"code":"0265T","type":"CPT"}],"standard_charges":[{"minimum":603.55,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":603.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0265U","type":"CPT"}],"standard_charges":[{"minimum":11464.24,"maximum":12046.76,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12046.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLT/RPL CRTD SNS DEV TOTAL","code_information":[{"code":"0266T","type":"CPT"}],"standard_charges":[{"minimum":589.29,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":589.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0266U","type":"CPT"}],"standard_charges":[{"minimum":7040,"maximum":16967.06,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16967.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16967.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16967.06,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7040,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLT/RPL CRTD SNS DEV LEAD","code_information":[{"code":"0267T","type":"CPT"}],"standard_charges":[{"minimum":357.08,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":357.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0267U","type":"CPT"}],"standard_charges":[{"minimum":14826.53,"maximum":16967.06,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16967.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16967.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16967.06,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14826.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLT/RPL CRTD SNS DEV GEN","code_information":[{"code":"0268T","type":"CPT"}],"standard_charges":[{"minimum":351.43,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":351.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0268U","type":"CPT"}],"standard_charges":[{"minimum":954.01,"maximum":1337.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":954.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":954.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":954.01,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REV/REMVL CRTD SNS DEV TOTAL","code_information":[{"code":"0269T","type":"CPT"}],"standard_charges":[{"minimum":1442.63,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1442.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0269U","type":"CPT"}],"standard_charges":[{"minimum":926.81,"maximum":1337.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"027","type":"MS-DRG"}],"standard_charges":[{"minimum":34539.88,"maximum":69255.03,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49025,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":49025,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69255.03,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51942.9,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51942.9,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34539.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":34539.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":41064.92,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46892,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":53701,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":34795,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":48668.22,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":49154.91,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":50128.27,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":49641.59,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":48668.22,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":48668.22,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":48668.22,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":49154.91,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":48668.22,"methodology":"case rate"}]}]},{"description":"SUPPLIES - GENERAL","code_information":[{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":267.4,"maximum":267.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REV/REMVL CRTD SNS DEV LEAD","code_information":[{"code":"0270T","type":"CPT"}],"standard_charges":[{"minimum":1186.04,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1186.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0270U","type":"CPT"}],"standard_charges":[{"minimum":1337.97,"maximum":2023.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2023.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2023.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2023.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONSTERILE SUPPLY","code_information":[{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":267.4,"maximum":267.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0271","type":"APR-DRG"}],"standard_charges":[{"minimum":10709,"maximum":10709,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10709,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10709,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10709,"methodology":"case rate"}]}]},{"description":"REV/REMVL CRTD SNS DEV GEN","code_information":[{"code":"0271T","type":"CPT"}],"standard_charges":[{"minimum":179.92,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":179.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0271U","type":"CPT"}],"standard_charges":[{"minimum":954.01,"maximum":1337.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":954.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":954.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":954.01,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0272","type":"APR-DRG"}],"standard_charges":[{"minimum":13247,"maximum":13247,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13247,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13247,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13247,"methodology":"case rate"}]}]},{"description":"STERILE SUPPLY","code_information":[{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":687.6,"maximum":687.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":687.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":687.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":687.6,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTERROGATE CRTD SNS DEV","code_information":[{"code":"0272T","type":"CPT"}],"standard_charges":[{"minimum":55.43,"maximum":65.67,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":65.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0272U","type":"CPT"}],"standard_charges":[{"minimum":1337.97,"maximum":2023.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2023.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2023.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2023.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0273","type":"APR-DRG"}],"standard_charges":[{"minimum":20763,"maximum":20763,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":20763,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":20763,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":20763,"methodology":"case rate"}]}]},{"description":"INTERROGATE CRTD SNS W/PGRMG","code_information":[{"code":"0273T","type":"CPT"}],"standard_charges":[{"minimum":55.43,"maximum":150.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":150.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0273U","type":"CPT"}],"standard_charges":[{"minimum":565.36,"maximum":1337.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":565.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":565.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":565.36,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0274","type":"APR-DRG"}],"standard_charges":[{"minimum":38984,"maximum":38984,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38984,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38984,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38984,"methodology":"case rate"}]}]},{"description":"PERQ LAMOT/LAM CRV/THRC","code_information":[{"code":"0274T","type":"CPT"}],"standard_charges":[{"minimum":2002.73,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2002.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0274U","type":"CPT"}],"standard_charges":[{"minimum":926.81,"maximum":1337.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PACEMAKER IMPLANT AND SUPPLIES","code_information":[{"code":"0275","type":"RC"}],"standard_charges":[{"minimum":23989.6,"maximum":23989.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23989.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":23989.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":23989.6,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_percentage":23.4,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_percentage":23.4,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ LAMOT/LAM LUMBAR","code_information":[{"code":"0275T","type":"CPT"}],"standard_charges":[{"minimum":6977,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0275U","type":"CPT"}],"standard_charges":[{"minimum":40.41,"maximum":54.7,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":54.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":54.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":40.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0276U","type":"CPT"}],"standard_charges":[{"minimum":926.81,"maximum":5386.83,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5386.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0277U","type":"CPT"}],"standard_charges":[{"minimum":926.81,"maximum":1337.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TEMPR","code_information":[{"code":"0278T","type":"CPT"}],"standard_charges":[{"minimum":34.72,"maximum":1597.98,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1597.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1597.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1597.98,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":34.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0278U","type":"CPT"}],"standard_charges":[{"minimum":565.36,"maximum":1337.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":565.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":565.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":565.36,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER SUPPLIES/DEVICES","code_information":[{"code":"0279","type":"RC"}],"standard_charges":[{"minimum":267.4,"maximum":267.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0279U","type":"CPT"}],"standard_charges":[{"minimum":25.37,"maximum":51.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":25.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL PROCEDURES WITH MCC","code_information":[{"code":"028","type":"MS-DRG"}],"standard_charges":[{"minimum":74957.06,"maximum":133014,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":129881,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":129881,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107506.73,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":80632.57,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":80632.57,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":85552.54,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":85552.54,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":101714.54,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":116147,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":133014,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":86185,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":74957.06,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":75706.64,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":77205.78,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":76456.21,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":74957.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":74957.06,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":74957.06,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":75706.64,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":74957.06,"methodology":"case rate"}]}]},{"description":"ONCOLOGY TREATMENT","code_information":[{"code":"0280","type":"RC"}],"standard_charges":[{"minimum":595,"maximum":919,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":755,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":919,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0280U","type":"CPT"}],"standard_charges":[{"minimum":37.99,"maximum":51.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0281U","type":"CPT"}],"standard_charges":[{"minimum":37.99,"maximum":51.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0282U","type":"CPT"}],"standard_charges":[{"minimum":1584,"maximum":2428.11,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2428.11,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2428.11,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2428.11,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1584,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0283U","type":"CPT"}],"standard_charges":[{"minimum":40.48,"maximum":51.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":40.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0284U","type":"CPT"}],"standard_charges":[{"minimum":37.99,"maximum":68.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":68.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":68.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0285U","type":"CPT"}],"standard_charges":[{"minimum":1165.56,"maximum":1165.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1165.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1165.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1165.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0286U","type":"CPT"}],"standard_charges":[{"minimum":269.81,"maximum":295.09,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":269.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":269.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":269.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":295.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0287U","type":"CPT"}],"standard_charges":[{"minimum":7241.12,"maximum":7920,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7241.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7241.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7241.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7920,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0288U","type":"CPT"}],"standard_charges":[{"minimum":7790.24,"maximum":8520.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7790.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7790.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7790.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":8520.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ONCOLOGY TREATMENT","code_information":[{"code":"0289","type":"RC"}],"standard_charges":[{"minimum":595,"maximum":919,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":755,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":919,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0289U","type":"CPT"}],"standard_charges":[{"minimum":1528.69,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS","code_information":[{"code":"029","type":"MS-DRG"}],"standard_charges":[{"minimum":48670.16,"maximum":75671,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65103,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":65103,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":72001.88,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":54003.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":54003.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48670.16,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":48670.16,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":57864.59,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":66075,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":75671,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":49030,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":55950.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":56509.62,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":57628.62,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":57069.12,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":55950.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":55950.11,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":55950.11,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":56509.62,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":55950.11,"methodology":"case rate"}]}]},{"description":"LASER INC FOR PKP/LKP RECIP","code_information":[{"code":"0290T","type":"CPT"}],"standard_charges":[{"minimum":180.91,"maximum":180.91,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":180.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0290U","type":"CPT"}],"standard_charges":[{"minimum":1528.69,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0291","type":"APR-DRG"}],"standard_charges":[{"minimum":12581,"maximum":12581,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12581,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12581,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12581,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0291U","type":"CPT"}],"standard_charges":[{"minimum":152.8,"maximum":152.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0292","type":"APR-DRG"}],"standard_charges":[{"minimum":12581,"maximum":12581,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12581,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12581,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12581,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0292U","type":"CPT"}],"standard_charges":[{"minimum":152.8,"maximum":152.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0293","type":"APR-DRG"}],"standard_charges":[{"minimum":17050,"maximum":17050,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17050,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17050,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17050,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0293U","type":"CPT"}],"standard_charges":[{"minimum":1528.69,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0294","type":"APR-DRG"}],"standard_charges":[{"minimum":30621,"maximum":30621,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":30621,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":30621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":30621,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0294U","type":"CPT"}],"standard_charges":[{"minimum":1528.69,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXT ECG COMPLETE","code_information":[{"code":"0295T","type":"CPT"}],"standard_charges":[{"minimum":194,"maximum":194,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":194,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0295U","type":"CPT"}],"standard_charges":[{"minimum":3815.68,"maximum":11957,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3815.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3815.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3815.68,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11957,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXT ECG RECORDING","code_information":[{"code":"0296T","type":"CPT"}],"standard_charges":[{"minimum":56.1,"maximum":56.1,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":56.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0296U","type":"CPT"}],"standard_charges":[{"minimum":3530.06,"maximum":3861,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3530.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3530.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3530.06,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3861,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXT ECG SCAN W/REPORT","code_information":[{"code":"0297T","type":"CPT"}],"standard_charges":[{"minimum":79.18,"maximum":79.18,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":79.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0297U","type":"CPT"}],"standard_charges":[{"minimum":1362.44,"maximum":1362.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXT ECG REVIEW AND INTERP","code_information":[{"code":"0298T","type":"CPT"}],"standard_charges":[{"minimum":58.72,"maximum":58.72,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":58.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0298U","type":"CPT"}],"standard_charges":[{"minimum":5872.56,"maximum":6423.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5872.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5872.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5872.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6423.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0299U","type":"CPT"}],"standard_charges":[{"minimum":1362.44,"maximum":1362.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"030","type":"MS-DRG"}],"standard_charges":[{"minimum":32922.84,"maximum":51187,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38923,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":38923,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44731.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":33549.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":33549.45,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32922.84,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32922.84,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":39142.4,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44696,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":51187,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":33166,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":47834.9,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":48313.25,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":49269.95,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":48791.6,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":47834.9,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":47834.9,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":47834.9,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":48313.25,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":47834.9,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0300U","type":"CPT"}],"standard_charges":[{"minimum":1362.44,"maximum":1362.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0301","type":"APR-DRG"}],"standard_charges":[{"minimum":12432,"maximum":12432,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12432,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12432,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12432,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0301U","type":"CPT"}],"standard_charges":[{"minimum":70.59,"maximum":70.59,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":70.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":70.59,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0302","type":"APR-DRG"}],"standard_charges":[{"minimum":17775,"maximum":17775,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17775,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17775,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17775,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0302U","type":"CPT"}],"standard_charges":[{"minimum":86.18,"maximum":86.18,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":86.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":86.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":86.18,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0303","type":"APR-DRG"}],"standard_charges":[{"minimum":24885,"maximum":24885,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24885,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24885,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24885,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0303U","type":"CPT"}],"standard_charges":[{"minimum":1058.48,"maximum":1058.48,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1058.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1058.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1058.48,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0304","type":"APR-DRG"}],"standard_charges":[{"minimum":35084,"maximum":35084,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":35084,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":35084,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":35084,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0304U","type":"CPT"}],"standard_charges":[{"minimum":1058.48,"maximum":1058.48,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1058.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1058.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1058.48,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0305U","type":"CPT"}],"standard_charges":[{"minimum":26.89,"maximum":26.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":26.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":26.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0306U","type":"CPT"}],"standard_charges":[{"minimum":831.35,"maximum":831.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":831.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":831.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":831.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0307U","type":"CPT"}],"standard_charges":[{"minimum":831.35,"maximum":831.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":831.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":831.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":831.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ OCULAR TELESCOPE PROSTH","code_information":[{"code":"0308T","type":"CPT"}],"standard_charges":[{"minimum":3021.62,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3206.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0308U","type":"CPT"}],"standard_charges":[{"minimum":859.65,"maximum":3125.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3125.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3125.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3125.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":859.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0309U","type":"CPT"}],"standard_charges":[{"minimum":116.85,"maximum":859.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":116.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":116.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":116.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":859.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES WITH MCC","code_information":[{"code":"031","type":"MS-DRG"}],"standard_charges":[{"minimum":58443.37,"maximum":102402,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102402,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":102402,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":82475.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":61858.67,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":61858.67,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58443.37,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":58443.37,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":69484.09,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":79343,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":90866,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":58876,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":60986.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":61596.51,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":62816.24,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":62206.38,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":60986.64,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":60986.64,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":60986.64,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":61596.51,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":60986.64,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0310U","type":"CPT"}],"standard_charges":[{"minimum":116.85,"maximum":859.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":116.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":116.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":116.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":859.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0311U","type":"CPT"}],"standard_charges":[{"minimum":17.78,"maximum":25.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":25.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":25.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LAPS IMPLTJ NSTIM VAGUS","code_information":[{"code":"0312T","type":"CPT"}],"standard_charges":[{"minimum":597.7,"maximum":597.7,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":597.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0312U","type":"CPT"}],"standard_charges":[{"minimum":1849.43,"maximum":2367.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1849.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LAPS RMVL NSTIM ARRAY VAGUS","code_information":[{"code":"0313T","type":"CPT"}],"standard_charges":[{"minimum":533.87,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":533.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0313U","type":"CPT"}],"standard_charges":[{"minimum":440.37,"maximum":7920,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":440.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":440.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":440.37,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7920,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LAPS RMVL VGL ARRYPLS GEN","code_information":[{"code":"0314T","type":"CPT"}],"standard_charges":[{"minimum":597.7,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":597.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0314U","type":"CPT"}],"standard_charges":[{"minimum":213.92,"maximum":213.92,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL VAGUS NERVE PLS GEN","code_information":[{"code":"0315T","type":"CPT"}],"standard_charges":[{"minimum":533.87,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":533.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0315U","type":"CPT"}],"standard_charges":[{"minimum":213.92,"maximum":213.92,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REPLC VAGUS NERVE PLS GEN","code_information":[{"code":"0316T","type":"CPT"}],"standard_charges":[{"minimum":597.7,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":597.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0316U","type":"CPT"}],"standard_charges":[{"minimum":41.05,"maximum":50.69,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":50.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":50.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":41.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ELEC ALYS VAGUS NRV PLS GEN","code_information":[{"code":"0317T","type":"CPT"}],"standard_charges":[{"minimum":44.07,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":44.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0317U","type":"CPT"}],"standard_charges":[{"minimum":2173.35,"maximum":4466,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2173.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4466,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0318U","type":"CPT"}],"standard_charges":[{"minimum":926.81,"maximum":926.81,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":926.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0319U","type":"CPT"}],"standard_charges":[{"minimum":9645.16,"maximum":9645.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9645.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9645.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9645.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES WITH CC","code_information":[{"code":"032","type":"MS-DRG"}],"standard_charges":[{"minimum":30577.5,"maximum":49503.89,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44825,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":44825,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49503.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":37129.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":37129.08,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30577.5,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":30577.5,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":36353.99,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41512,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":47541,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":30804,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":46626.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":47092.52,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48025.04,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":47558.78,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":46626.25,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":46626.25,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":46626.25,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":47092.52,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":46626.25,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0320U","type":"CPT"}],"standard_charges":[{"minimum":10654.74,"maximum":10654.74,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10654.74,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10654.74,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10654.74,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0321U","type":"CPT"}],"standard_charges":[{"minimum":1060.16,"maximum":1396.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1060.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1060.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1060.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1396.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0322U","type":"CPT"}],"standard_charges":[{"minimum":1650,"maximum":2232.68,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2232.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2232.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2232.68,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1650,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0323U","type":"CPT"}],"standard_charges":[{"minimum":1173.66,"maximum":4677.64,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1173.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1173.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1173.66,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4677.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0324U","type":"CPT"}],"standard_charges":[{"minimum":2446.71,"maximum":2446.71,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2446.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0325U","type":"CPT"}],"standard_charges":[{"minimum":2446.71,"maximum":2446.71,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2446.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0326U","type":"CPT"}],"standard_charges":[{"minimum":7700,"maximum":14643.36,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14643.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14643.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14643.36,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7700,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0327U","type":"CPT"}],"standard_charges":[{"minimum":1749,"maximum":3797.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1749,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0328U","type":"CPT"}],"standard_charges":[{"minimum":251.75,"maximum":545.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":545.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":545.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":545.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MNTR IO PRESS 24HRS/> UNI/BI","code_information":[{"code":"0329T","type":"CPT"}],"standard_charges":[{"minimum":223.05,"maximum":1988.49,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":223.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":223.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":223.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1988.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0329U","type":"CPT"}],"standard_charges":[{"minimum":15248.6,"maximum":15248.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15248.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15248.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15248.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"033","type":"MS-DRG"}],"standard_charges":[{"minimum":23040.31,"maximum":44024.31,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32393,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":32393,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36551.27,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":27414.31,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":27414.31,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23040.31,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":23040.31,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":27392.93,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31280,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":35822,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":23211,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42742.04,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":43169.47,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":44024.31,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43596.89,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42742.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42742.04,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42742.04,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":43169.47,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42742.04,"methodology":"case rate"}]}]},{"description":"RADIATION THERAPY","code_information":[{"code":"0330","type":"RC"}],"standard_charges":[{"minimum":1728,"maximum":1728,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1728,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TEAR FILM IMG UNI/BI W/IR","code_information":[{"code":"0330T","type":"CPT"}],"standard_charges":[{"minimum":41.98,"maximum":93.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":41.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":41.98,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":93.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0330U","type":"CPT"}],"standard_charges":[{"minimum":56.46,"maximum":916.92,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":56.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":916.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CHEMO ADMINISTRATION","code_information":[{"code":"0331","type":"RC"}],"standard_charges":[{"minimum":587,"maximum":709,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":700,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":587,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":709,"methodology":"case rate"}]}]},{"description":"HEART SYMP IMAGE PLNR","code_information":[{"code":"0331T","type":"CPT"}],"standard_charges":[{"minimum":439.05,"maximum":613.64,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":613.64,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":613.64,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":613.64,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":439.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0331U","type":"CPT"}],"standard_charges":[{"minimum":292.42,"maximum":292.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":292.42,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CHEMO ADMINISTRATION","code_information":[{"code":"0332","type":"RC"}],"standard_charges":[{"minimum":587,"maximum":709,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":700,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":587,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":709,"methodology":"case rate"}]}]},{"description":"HEART SYMP IMAGE PLNR SPECT","code_information":[{"code":"0332T","type":"CPT"}],"standard_charges":[{"minimum":490.34,"maximum":718.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":718.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":718.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":718.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":490.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0332U","type":"CPT"}],"standard_charges":[{"minimum":2367.25,"maximum":2367.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2367.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RADIATION THERAPY","code_information":[{"code":"0333","type":"RC"}],"standard_charges":[{"minimum":1728,"maximum":1728,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1728,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VISUAL EP SCR ACUITY AUTO","code_information":[{"code":"0333T","type":"CPT"}],"standard_charges":[{"minimum":144.74,"maximum":403.43,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":144.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0333U","type":"CPT"}],"standard_charges":[{"minimum":247.54,"maximum":247.54,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":247.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":247.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":247.54,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0334U","type":"CPT"}],"standard_charges":[{"minimum":6423.12,"maximum":9313.77,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9313.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9313.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9313.77,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6423.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CHEMO ADMINISTRATION","code_information":[{"code":"0335","type":"RC"}],"standard_charges":[{"minimum":587,"maximum":709,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":700,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":587,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":709,"methodology":"case rate"}]}]},{"description":"INSJ SINUS TARSI IMPLANT","code_information":[{"code":"0335T","type":"CPT"}],"standard_charges":[{"minimum":1106.56,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1106.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0335U","type":"CPT"}],"standard_charges":[{"minimum":11464.24,"maximum":11494.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11494.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0336U","type":"CPT"}],"standard_charges":[{"minimum":5664.23,"maximum":11464.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11464.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5664.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0337U","type":"CPT"}],"standard_charges":[{"minimum":226.79,"maximum":226.79,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRNSCTH RENAL SYMP DENRV UNL","code_information":[{"code":"0338T","type":"CPT"}],"standard_charges":[{"minimum":530.2,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":530.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0338U","type":"CPT"}],"standard_charges":[{"minimum":226.79,"maximum":226.79,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":226.79,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RADIATION THERAPY","code_information":[{"code":"0339","type":"RC"}],"standard_charges":[{"minimum":1728,"maximum":1728,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1728,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRNSCTH RENAL SYMP DENRV BIL","code_information":[{"code":"0339T","type":"CPT"}],"standard_charges":[{"minimum":638,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3959.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3959.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3959.43,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":638,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0339U","type":"CPT"}],"standard_charges":[{"minimum":534.8,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CAROTID ARTERY STENT PROCEDURES WITH MCC","code_information":[{"code":"034","type":"MS-DRG"}],"standard_charges":[{"minimum":51959.65,"maximum":76803,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69277.36,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51959.65,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51959.65,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55388.18,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":55388.18,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":56913.62,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67584,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":55798,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":76803,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":59412.17,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":60006.3,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":61194.54,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":60600.42,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":59412.17,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":59412.17,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":59412.17,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":60006.3,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":59412.17,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0340U","type":"CPT"}],"standard_charges":[{"minimum":534.8,"maximum":8624,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":8624,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0341U","type":"CPT"}],"standard_charges":[{"minimum":3797.08,"maximum":3797.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3797.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"THXP APHERESIS W/HDL DELIP","code_information":[{"code":"0342T","type":"CPT"}],"standard_charges":[{"minimum":546.37,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":546.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0342U","type":"CPT"}],"standard_charges":[{"minimum":58.6,"maximum":1973.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":58.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":58.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1973.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0343U","type":"CPT"}],"standard_charges":[{"minimum":105.89,"maximum":1672,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":105.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":105.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":105.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1672,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0344U","type":"CPT"}],"standard_charges":[{"minimum":327.83,"maximum":327.83,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":327.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":327.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":327.83,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRANSCATH MTRAL VLVE REPAIR","code_information":[{"code":"0345T","type":"CPT"}],"standard_charges":[{"minimum":3757.56,"maximum":15367.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3757.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0345U","type":"CPT"}],"standard_charges":[{"minimum":534.8,"maximum":2939.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2939.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0346U","type":"CPT"}],"standard_charges":[{"minimum":67.84,"maximum":67.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":67.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":67.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INS BONE DEVICE FOR RSA","code_information":[{"code":"0347T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0347U","type":"CPT"}],"standard_charges":[{"minimum":534.8,"maximum":2939.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2939.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RSA SPINE EXAM","code_information":[{"code":"0348T","type":"CPT"}],"standard_charges":[{"minimum":90.27,"maximum":332.91,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":332.91,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":332.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":90.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0348U","type":"CPT"}],"standard_charges":[{"minimum":534.8,"maximum":1632.99,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1632.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RSA UPPER EXTR EXAM","code_information":[{"code":"0349T","type":"CPT"}],"standard_charges":[{"minimum":332.91,"maximum":387.86,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":332.91,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":332.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":387.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0349U","type":"CPT"}],"standard_charges":[{"minimum":534.8,"maximum":1632.99,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1632.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CAROTID ARTERY STENT PROCEDURES WITH CC","code_information":[{"code":"035","type":"MS-DRG"}],"standard_charges":[{"minimum":32646,"maximum":51733.9,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51733.9,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":38801.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":38801.64,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32646,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32646,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":33545.11,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39834,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":32887,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":45268,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":47692.23,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":48169.16,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":49123,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":48646.08,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":47692.23,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":47692.23,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":47692.23,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":48169.16,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":47692.23,"methodology":"case rate"}]}]},{"description":"RSA LOWER EXTR EXAM","code_information":[{"code":"0350T","type":"CPT"}],"standard_charges":[{"minimum":237.06,"maximum":337.3,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":237.06,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":237.06,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":337.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0350U","type":"CPT"}],"standard_charges":[{"minimum":534.8,"maximum":2939.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":534.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2939.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRAOP OCT BRST/NODE SPEC","code_information":[{"code":"0351T","type":"CPT"}],"standard_charges":[{"minimum":841.39,"maximum":3088.39,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":841.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0351U","type":"CPT"}],"standard_charges":[{"minimum":213.92,"maximum":573.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":213.92,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":573.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OCT BRST/NODE IR PER SPEC","code_information":[{"code":"0352T","type":"CPT"}],"standard_charges":[{"minimum":841.39,"maximum":3088.39,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":841.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0352U","type":"CPT"}],"standard_charges":[{"minimum":313.79,"maximum":740.58,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":740.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":740.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":740.58,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":313.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRAOP OCT BREAST CAVITY","code_information":[{"code":"0353T","type":"CPT"}],"standard_charges":[{"minimum":324.98,"maximum":3088.39,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":324.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0353U","type":"CPT"}],"standard_charges":[{"minimum":98.82,"maximum":154.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":154.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OCT BREAST SURG CAVITY IR","code_information":[{"code":"0354T","type":"CPT"}],"standard_charges":[{"minimum":841.39,"maximum":3088.39,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3088.39,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":841.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0354U","type":"CPT"}],"standard_charges":[{"minimum":77.2,"maximum":128.43,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":128.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":128.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":128.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":77.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"GI TRACT CAPSULE ENDOSCOPY","code_information":[{"code":"0355T","type":"CPT"}],"standard_charges":[{"minimum":550,"maximum":4625.95,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4625.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":4625.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":550,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0355U","type":"CPT"}],"standard_charges":[{"minimum":59.4,"maximum":59.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSRT DRUG DEVICE FOR IOP","code_information":[{"code":"0356T","type":"CPT"}],"standard_charges":[{"minimum":60.98,"maximum":60.98,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":60.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0356U","type":"CPT"}],"standard_charges":[{"minimum":152.8,"maximum":152.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BIA WHOLE BODY","code_information":[{"code":"0358T","type":"CPT"}],"standard_charges":[{"minimum":19.67,"maximum":116.66,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":116.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":116.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":116.66,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0358U","type":"CPT"}],"standard_charges":[{"minimum":67.84,"maximum":67.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":67.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":67.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0359U","type":"CPT"}],"standard_charges":[{"minimum":2140.16,"maximum":2140.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2140.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"036","type":"MS-DRG"}],"standard_charges":[{"minimum":25671.02,"maximum":46237.02,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46237.02,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":34678.85,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":34678.85,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25671.02,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25671.02,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":26378.02,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31323,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":25861,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":35596,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44097.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44538.73,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45420.69,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44979.71,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44097.75,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44097.75,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44097.75,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44538.73,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44097.75,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0360U","type":"CPT"}],"standard_charges":[{"minimum":7006.19,"maximum":7006.19,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7006.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7006.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7006.19,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0361U","type":"CPT"}],"standard_charges":[{"minimum":18.72,"maximum":18.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BHV ID SUPRT ASSMT EA 15 MIN","code_information":[{"code":"0362T","type":"CPT"}],"standard_charges":[{"minimum":205.9,"maximum":272.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":205.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":205.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":205.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":272.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0362U","type":"CPT"}],"standard_charges":[{"minimum":6042.63,"maximum":6042.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6042.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":6042.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":6042.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0363U","type":"CPT"}],"standard_charges":[{"minimum":1337,"maximum":1337,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0364U","type":"CPT"}],"standard_charges":[{"minimum":373.6,"maximum":373.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":373.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":373.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":373.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0365U","type":"CPT"}],"standard_charges":[{"minimum":51.46,"maximum":51.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0366U","type":"CPT"}],"standard_charges":[{"minimum":51.46,"maximum":51.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0367U","type":"CPT"}],"standard_charges":[{"minimum":51.46,"maximum":51.46,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0368U","type":"CPT"}],"standard_charges":[{"minimum":162.01,"maximum":162.01,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":162.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":162.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":162.01,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0369U","type":"CPT"}],"standard_charges":[{"minimum":838.34,"maximum":838.34,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":838.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":838.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":838.34,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACRANIAL PROCEDURES WITH MCC","code_information":[{"code":"037","type":"MS-DRG"}],"standard_charges":[{"minimum":38095.77,"maximum":74510,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70936,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":70936,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50792.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":38095.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":38095.77,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47923.39,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":47923.39,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":56976.75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65061,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":74510,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":48278,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":55565.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":56120.94,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":57232.24,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":56676.59,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":55565.28,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":55565.28,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":55565.28,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":56120.94,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":55565.28,"methodology":"case rate"}]}]},{"description":"ANESTHESIA - GENERAL","code_information":[{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":897.7,"maximum":897.7,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":897.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":897.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":897.7,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0370U","type":"CPT"}],"standard_charges":[{"minimum":141.23,"maximum":141.23,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":141.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":141.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":141.23,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANESTHESIA - ANESTHESIA INCIDENT TO RADIOLOGY","code_information":[{"code":"0371","type":"RC"}],"standard_charges":[{"minimum":420.2,"maximum":420.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":420.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":420.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":420.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0371U","type":"CPT"}],"standard_charges":[{"minimum":716.33,"maximum":716.33,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANESTHESIA - ANESTHESIA INCIDENT TO OTHER DIAGNOSTIC SERVICES","code_information":[{"code":"0372","type":"RC"}],"standard_charges":[{"minimum":267.4,"maximum":267.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0372U","type":"CPT"}],"standard_charges":[{"minimum":716.33,"maximum":716.33,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ADAPT BHV TX EA 15 MIN","code_information":[{"code":"0373T","type":"CPT"}],"standard_charges":[{"minimum":11.55,"maximum":411.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":411.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":411.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":411.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0373U","type":"CPT"}],"standard_charges":[{"minimum":553.86,"maximum":553.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":553.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":553.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":553.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANESTHESIA - ACUPUNCTURE","code_information":[{"code":"0374","type":"RC"}],"standard_charges":[{"minimum":267.4,"maximum":267.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0374U","type":"CPT"}],"standard_charges":[{"minimum":716.33,"maximum":716.33,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0375U","type":"CPT"}],"standard_charges":[{"minimum":152.8,"maximum":152.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":152.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT ANT SEGMENT DRAIN INT","code_information":[{"code":"0376T","type":"CPT"}],"standard_charges":[{"minimum":502.92,"maximum":502.92,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":502.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0376U","type":"CPT"}],"standard_charges":[{"minimum":1528.69,"maximum":1528.69,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0377U","type":"CPT"}],"standard_charges":[{"minimum":82.51,"maximum":82.51,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":82.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":82.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":82.51,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VISUAL FIELD ASSMNT REV/RPRT","code_information":[{"code":"0378T","type":"CPT"}],"standard_charges":[{"minimum":64.42,"maximum":142.33,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":142.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":142.33,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":64.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0378U","type":"CPT"}],"standard_charges":[{"minimum":312.17,"maximum":312.17,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":312.17,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANESTHESIA - OTHER","code_information":[{"code":"0379","type":"RC"}],"standard_charges":[{"minimum":267.4,"maximum":267.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":267.4,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIS FIELD ASSMNT TECH SUPPT","code_information":[{"code":"0379T","type":"CPT"}],"standard_charges":[{"minimum":197.3,"maximum":978.34,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":978.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0379U","type":"CPT"}],"standard_charges":[{"minimum":1362.44,"maximum":1362.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACRANIAL PROCEDURES WITH CC","code_information":[{"code":"038","type":"MS-DRG"}],"standard_charges":[{"minimum":22713.78,"maximum":43850.99,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36345,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":36345,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32965.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":24724.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":24724.8,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22713.78,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":22713.78,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":27004.71,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30836,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":35315,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":22882,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42573.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42999.51,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43850.99,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43425.25,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42573.77,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42573.77,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42573.77,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42999.51,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42573.77,"methodology":"case rate"}]}]},{"description":"BLOOD ","code_information":[{"code":"0380","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0380U","type":"CPT"}],"standard_charges":[{"minimum":1245.93,"maximum":1245.93,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1245.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1245.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1245.93,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0381","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0381U","type":"CPT"}],"standard_charges":[{"minimum":216.44,"maximum":216.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":216.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":216.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":216.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0382","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0382U","type":"CPT"}],"standard_charges":[{"minimum":11.08,"maximum":11.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0383","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0383U","type":"CPT"}],"standard_charges":[{"minimum":11.08,"maximum":11.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0384","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0384U","type":"CPT"}],"standard_charges":[{"minimum":9.97,"maximum":9.97,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9.97,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0385","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0385U","type":"CPT"}],"standard_charges":[{"minimum":37.25,"maximum":37.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":37.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":37.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0386","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"BLOOD ","code_information":[{"code":"0387","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0387U","type":"CPT"}],"standard_charges":[{"minimum":1528.69,"maximum":1528.69,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1528.69,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0388","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0388U","type":"CPT"}],"standard_charges":[{"minimum":3261.71,"maximum":3261.71,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3261.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3261.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3261.71,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0389","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0389U","type":"CPT"}],"standard_charges":[{"minimum":78.96,"maximum":78.96,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":78.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":78.96,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EXTRACRANIAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"039","type":"MS-DRG"}],"standard_charges":[{"minimum":16198.78,"maximum":40392.82,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24485.55,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18364.74,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18364.74,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16198.78,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":16198.78,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16644.91,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21992,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":25185,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":16319,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39216.33,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39608.5,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40392.82,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40000.66,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39216.33,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39216.33,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39216.33,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39608.5,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39216.33,"methodology":"case rate"}]}]},{"description":"BLOOD ","code_information":[{"code":"0390","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0390U","type":"CPT"}],"standard_charges":[{"minimum":48.63,"maximum":48.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":48.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":48.63,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0391","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0391U","type":"CPT"}],"standard_charges":[{"minimum":1337,"maximum":1337,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1337,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0392","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0392U","type":"CPT"}],"standard_charges":[{"minimum":764,"maximum":764,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0393U","type":"CPT"}],"standard_charges":[{"minimum":19.41,"maximum":19.41,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.41,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19.41,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HDR ELCTRNC SKN SURF BRCHYTX","code_information":[{"code":"0394T","type":"CPT"}],"standard_charges":[{"minimum":116.71,"maximum":2482.47,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2482.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2482.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2482.47,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":702.06,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":702.06,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":116.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0394U","type":"CPT"}],"standard_charges":[{"minimum":124.99,"maximum":124.99,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":124.99,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":124.99,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HDR ELCTR NTRST/NTRCV BRCHTX","code_information":[{"code":"0395T","type":"CPT"}],"standard_charges":[{"minimum":420.66,"maximum":2482.47,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2482.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2482.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2482.47,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2199.57,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2199.57,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":420.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0395U","type":"CPT"}],"standard_charges":[{"minimum":5004.43,"maximum":5004.43,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5004.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5004.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5004.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0396U","type":"CPT"}],"standard_charges":[{"minimum":979.91,"maximum":979.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":979.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":979.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":979.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ERCP W/OPTICAL ENDOMICROSCPY","code_information":[{"code":"0397T","type":"CPT"}],"standard_charges":[{"minimum":206.01,"maximum":2262,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":206.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MRGFUS STRTCTC LES ABLTJ","code_information":[{"code":"0398T","type":"CPT"}],"standard_charges":[{"minimum":2904.81,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2904.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0398U","type":"CPT"}],"standard_charges":[{"minimum":4416.03,"maximum":4416.03,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4416.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4416.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4416.03,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLOOD ","code_information":[{"code":"0399","type":"RC"}],"standard_charges":[{"minimum":427,"maximum":487,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":427,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":486,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0399U","type":"CPT"}],"standard_charges":[{"minimum":1508.59,"maximum":1508.59,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1508.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1508.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1508.59,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC","code_information":[{"code":"040","type":"MS-DRG"}],"standard_charges":[{"minimum":44807.57,"maximum":92752,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":92752,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":92752,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59741.56,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":44807.57,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":44807.57,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54665.55,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":54665.55,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":64992.59,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":74215,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":84992,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":55070,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":59039.78,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":59630.18,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":60810.98,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":60220.58,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":59039.78,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":59039.78,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":59039.78,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":59630.18,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":59039.78,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0400U","type":"CPT"}],"standard_charges":[{"minimum":4925.09,"maximum":4925.09,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4925.09,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4925.09,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4925.09,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0401","type":"APR-DRG"}],"standard_charges":[{"minimum":6530,"maximum":6530,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6530,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6530,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6530,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0401U","type":"CPT"}],"standard_charges":[{"minimum":1332.8,"maximum":1332.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1332.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1332.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1332.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0402","type":"APR-DRG"}],"standard_charges":[{"minimum":8842,"maximum":8842,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8842,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8842,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8842,"methodology":"case rate"}]}]},{"description":"COLGN CROSS-LINK CRN MED SEP","code_information":[{"code":"0402T","type":"CPT"}],"standard_charges":[{"minimum":1139.75,"maximum":3476.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3476.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3476.2,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3476.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1139.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0402U","type":"CPT"}],"standard_charges":[{"minimum":98.82,"maximum":98.82,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":98.82,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0403","type":"APR-DRG"}],"standard_charges":[{"minimum":13280,"maximum":13280,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13280,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13280,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13280,"methodology":"case rate"}]}]},{"description":"DIABETES PREV STANDARD CURR","code_information":[{"code":"0403T","type":"CPT"}],"standard_charges":[{"minimum":67.32,"maximum":442.28,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":442.28,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":442.28,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":442.28,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":67.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0403U","type":"CPT"}],"standard_charges":[{"minimum":764,"maximum":764,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0404","type":"APR-DRG"}],"standard_charges":[{"minimum":22211,"maximum":22211,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":22211,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":22211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":22211,"methodology":"case rate"}]}]},{"description":"TRNSCRV UTERIN FIBROID ABLTJ","code_information":[{"code":"0404T","type":"CPT"}],"standard_charges":[{"minimum":1274.97,"maximum":2945.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1274.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0404U","type":"CPT"}],"standard_charges":[{"minimum":3815.68,"maximum":3815.68,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3815.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3815.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3815.68,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0405U","type":"CPT"}],"standard_charges":[{"minimum":971.96,"maximum":971.96,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":971.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":971.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":971.96,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0406U","type":"CPT"}],"standard_charges":[{"minimum":268.62,"maximum":268.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":268.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":268.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":268.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0407U","type":"CPT"}],"standard_charges":[{"minimum":1910.88,"maximum":1910.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1910.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1910.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1910.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLC CARDIAC MODULJ SYS","code_information":[{"code":"0408T","type":"CPT"}],"standard_charges":[{"minimum":2143.68,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2143.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0408U","type":"CPT"}],"standard_charges":[{"minimum":86.48,"maximum":86.48,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":86.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":86.48,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":86.48,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLC CAR MODULJ PLS GN","code_information":[{"code":"0409T","type":"CPT"}],"standard_charges":[{"minimum":799.39,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":799.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0409U","type":"CPT"}],"standard_charges":[{"minimum":794.25,"maximum":794.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":794.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":794.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":794.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR","code_information":[{"code":"041","type":"MS-DRG"}],"standard_charges":[{"minimum":31669.25,"maximum":50079,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50079,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":50079,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43308.32,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":32482.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":32482.26,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31669.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":31669.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":32541.45,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42995,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":49238,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":31903,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":47188.87,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":47660.76,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48604.54,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":48132.65,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":47188.87,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":47188.87,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":47188.87,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":47660.76,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":47188.87,"methodology":"case rate"}]}]},{"description":"INSJ/RPLC CAR MODULJ ATR ELT","code_information":[{"code":"0410T","type":"CPT"}],"standard_charges":[{"minimum":709.74,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":709.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0410U","type":"CPT"}],"standard_charges":[{"minimum":1362.44,"maximum":1362.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0411","type":"APR-DRG"}],"standard_charges":[{"minimum":4985,"maximum":4985,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4985,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4985,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4985,"methodology":"case rate"}]}]},{"description":"INSJ/RPLC CAR MODULJ VNT ELT","code_information":[{"code":"0411T","type":"CPT"}],"standard_charges":[{"minimum":709.74,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":709.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0411U","type":"CPT"}],"standard_charges":[{"minimum":764,"maximum":764,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":764,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0412","type":"APR-DRG"}],"standard_charges":[{"minimum":5573,"maximum":5573,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5573,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5573,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5573,"methodology":"case rate"}]}]},{"description":"RMVL CARDIAC MODULJ PLS GEN","code_information":[{"code":"0412T","type":"CPT"}],"standard_charges":[{"minimum":585.93,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":585.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0412U","type":"CPT"}],"standard_charges":[{"minimum":96.91,"maximum":96.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":96.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":96.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":96.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HYPERBARIC","code_information":[{"code":"0413","type":"RC"}],"standard_charges":[{"minimum":3221,"maximum":3917,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3845,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3221,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3917,"methodology":"case rate"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0413","type":"APR-DRG"}],"standard_charges":[{"minimum":7443,"maximum":7443,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7443,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7443,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7443,"methodology":"case rate"}]}]},{"description":"RMVL CAR MODULJ TRANVNS ELT","code_information":[{"code":"0413T","type":"CPT"}],"standard_charges":[{"minimum":659.91,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":659.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":659.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":659.91,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0413U","type":"CPT"}],"standard_charges":[{"minimum":208.88,"maximum":208.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0414","type":"APR-DRG"}],"standard_charges":[{"minimum":11662,"maximum":11662,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11662,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11662,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11662,"methodology":"case rate"}]}]},{"description":"RMVL  RPL CAR MODULJ PLS GN","code_information":[{"code":"0414T","type":"CPT"}],"standard_charges":[{"minimum":846.32,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":846.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0414U","type":"CPT"}],"standard_charges":[{"minimum":1362.44,"maximum":1362.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1362.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REPOS CAR MODULJ TRANVNS ELT","code_information":[{"code":"0415T","type":"CPT"}],"standard_charges":[{"minimum":703.98,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":703.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0415U","type":"CPT"}],"standard_charges":[{"minimum":168.5,"maximum":168.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":168.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":168.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":168.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RELOC SKIN POCKET PLS GEN","code_information":[{"code":"0416T","type":"CPT"}],"standard_charges":[{"minimum":745.84,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":745.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0416U","type":"CPT"}],"standard_charges":[{"minimum":716.33,"maximum":716.33,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":716.33,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PRGRMG EVAL CARDIAC MODULJ","code_information":[{"code":"0417T","type":"CPT"}],"standard_charges":[{"minimum":138.25,"maximum":161.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":138.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":138.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":138.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":161.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0417U","type":"CPT"}],"standard_charges":[{"minimum":10891.85,"maximum":10891.85,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10891.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10891.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10891.85,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTERRO EVAL CARDIAC MODULJ","code_information":[{"code":"0418T","type":"CPT"}],"standard_charges":[{"minimum":63.49,"maximum":126.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":63.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":63.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":63.49,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":126.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0418U","type":"CPT"}],"standard_charges":[{"minimum":6500.88,"maximum":6500.88,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6500.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":6500.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":6500.88,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DSTRJ NEUROFIBROMA XTNSV","code_information":[{"code":"0419T","type":"CPT"}],"standard_charges":[{"minimum":366.45,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":366.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0419U","type":"CPT"}],"standard_charges":[{"minimum":1027.47,"maximum":1027.47,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1027.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1027.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1027.47,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"042","type":"MS-DRG"}],"standard_charges":[{"minimum":24699.94,"maximum":44905.23,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40114,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":40114,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34340.39,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":25756.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":25756.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24699.94,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24699.94,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":29366.08,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33533,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":38403,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":24883,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43597.31,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44033.29,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":44905.23,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44469.26,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43597.31,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43597.31,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43597.31,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44033.29,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43597.31,"methodology":"case rate"}]}]},{"description":"PHYSICAL THERAPY","code_information":[{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"DSTRJ NEUROFIBROMA XTNSV","code_information":[{"code":"0420T","type":"CPT"}],"standard_charges":[{"minimum":829.03,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":829.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0421","type":"APR-DRG"}],"standard_charges":[{"minimum":4288,"maximum":4288,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4288,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4288,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4288,"methodology":"case rate"}]}]},{"description":"PHYSICAL THERAPY","code_information":[{"code":"0421","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"WATERJET PROSTATE ABLTJ CMPL","code_information":[{"code":"0421T","type":"CPT"}],"standard_charges":[{"minimum":1586.88,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1586.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0422","type":"APR-DRG"}],"standard_charges":[{"minimum":5145,"maximum":5145,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5145,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5145,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5145,"methodology":"case rate"}]}]},{"description":"PHYSICAL THERAPY","code_information":[{"code":"0422","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"TACTILE BREAST IMG UNI/BI","code_information":[{"code":"0422T","type":"CPT"}],"standard_charges":[{"minimum":233.99,"maximum":648.41,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":648.41,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":648.41,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":648.41,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":233.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0423","type":"APR-DRG"}],"standard_charges":[{"minimum":7799,"maximum":7799,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7799,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7799,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7799,"methodology":"case rate"}]}]},{"description":"PHYSICAL THERAPY","code_information":[{"code":"0423","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0424","type":"APR-DRG"}],"standard_charges":[{"minimum":16424,"maximum":16424,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16424,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16424,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16424,"methodology":"case rate"}]}]},{"description":"PHYSICAL THERAPY","code_information":[{"code":"0424","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"INSJ/RPLC NSTIM APNEA COMPL","code_information":[{"code":"0424T","type":"CPT"}],"standard_charges":[{"minimum":803.07,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":803.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLC NSTIM APNEA SEN LD","code_information":[{"code":"0425T","type":"CPT"}],"standard_charges":[{"minimum":841.28,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":841.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLC NSTIM APNEA STM LD","code_information":[{"code":"0426T","type":"CPT"}],"standard_charges":[{"minimum":248.73,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":248.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLC NSTIM APNEA PLS GN","code_information":[{"code":"0427T","type":"CPT"}],"standard_charges":[{"minimum":279.07,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":279.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL NSTIM APNEA PLS GEN","code_information":[{"code":"0428T","type":"CPT"}],"standard_charges":[{"minimum":712.69,"maximum":1321.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":712.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PHYSICAL THERAPY","code_information":[{"code":"0429","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"RMVL NSTIM APNEA SEN LD","code_information":[{"code":"0429T","type":"CPT"}],"standard_charges":[{"minimum":1100.07,"maximum":1321.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OCCUPATIONAL THERAPY","code_information":[{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"RMVL NSTIM APNEA STIMJ LD","code_information":[{"code":"0430T","type":"CPT"}],"standard_charges":[{"minimum":492.78,"maximum":1044.36,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":492.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":492.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":492.78,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1044.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0431","type":"APR-DRG"}],"standard_charges":[{"minimum":5447,"maximum":5447,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5447,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5447,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5447,"methodology":"case rate"}]}]},{"description":"OCCUPATIONAL THERAPY","code_information":[{"code":"0431","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"RMVL/RPLC NSTIM APNEA PLS GN","code_information":[{"code":"0431T","type":"CPT"}],"standard_charges":[{"minimum":766.81,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":766.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0432","type":"APR-DRG"}],"standard_charges":[{"minimum":7482,"maximum":7482,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7482,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7482,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7482,"methodology":"case rate"}]}]},{"description":"OCCUPATIONAL THERAPY","code_information":[{"code":"0432","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"REPOS NSTIM APNEA STIMJ LD","code_information":[{"code":"0432T","type":"CPT"}],"standard_charges":[{"minimum":1188.62,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1188.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0433","type":"APR-DRG"}],"standard_charges":[{"minimum":11583,"maximum":11583,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11583,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11583,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11583,"methodology":"case rate"}]}]},{"description":"OCCUPATIONAL THERAPY","code_information":[{"code":"0433","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"REPOS NSTIM APNEA SENSING LD","code_information":[{"code":"0433T","type":"CPT"}],"standard_charges":[{"minimum":703.98,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":703.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0434","type":"APR-DRG"}],"standard_charges":[{"minimum":22361,"maximum":22361,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":22361,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":22361,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":22361,"methodology":"case rate"}]}]},{"description":"OCCUPATIONAL THERAPY","code_information":[{"code":"0434","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"INTERRO EVAL NPGS APNEA","code_information":[{"code":"0434T","type":"CPT"}],"standard_charges":[{"minimum":41.56,"maximum":370.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":41.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PRGRMG EVAL NPGS APNEA 1 SES","code_information":[{"code":"0435T","type":"CPT"}],"standard_charges":[{"minimum":126.9,"maximum":370.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":126.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PRGRMG EVAL NPGS APNEA STUDY","code_information":[{"code":"0436T","type":"CPT"}],"standard_charges":[{"minimum":107.12,"maximum":370.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":370.65,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":107.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IMPLTJ SYNTH RNFCMT ABDL WAL","code_information":[{"code":"0437T","type":"CPT"}],"standard_charges":[{"minimum":605.64,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":605.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OCCUPATIONAL THERAPY","code_information":[{"code":"0439","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"MYOCRD CONTRAST PRFUJ ECHO","code_information":[{"code":"0439T","type":"CPT"}],"standard_charges":[{"minimum":203.32,"maximum":311.83,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":311.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":311.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":311.83,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":203.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"ABLTJ PERC UXTR/PERPH NRV","code_information":[{"code":"0440T","type":"CPT"}],"standard_charges":[{"minimum":446.67,"maximum":921.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":446.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0441","type":"APR-DRG"}],"standard_charges":[{"minimum":5245,"maximum":5245,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5245,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5245,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5245,"methodology":"case rate"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"0441","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"ABLTJ PERC LXTR/PERPH NRV","code_information":[{"code":"0441T","type":"CPT"}],"standard_charges":[{"minimum":446.67,"maximum":921.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":921.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":446.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0442","type":"APR-DRG"}],"standard_charges":[{"minimum":6928,"maximum":6928,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6928,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6928,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6928,"methodology":"case rate"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"0442","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"ABLTJ PERC PLEX/TRNCL NRV","code_information":[{"code":"0442T","type":"CPT"}],"standard_charges":[{"minimum":257.93,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":257.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0443","type":"APR-DRG"}],"standard_charges":[{"minimum":9819,"maximum":9819,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9819,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9819,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9819,"methodology":"case rate"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"0443","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"R-T SPCTRL ALYS PRST8 TISS","code_information":[{"code":"0443T","type":"CPT"}],"standard_charges":[{"minimum":52.45,"maximum":56.34,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":52.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":52.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":56.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0444","type":"APR-DRG"}],"standard_charges":[{"minimum":13595,"maximum":13595,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13595,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13595,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13595,"methodology":"case rate"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"0444","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"1ST PLMT DRUG ELUT OC INS","code_information":[{"code":"0444T","type":"CPT"}],"standard_charges":[{"minimum":440.66,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":440.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SBSQT PLMT DRUG ELUT OC INS","code_information":[{"code":"0445T","type":"CPT"}],"standard_charges":[{"minimum":599.21,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":599.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ IMPLTBL GLUCOSE SENSOR","code_information":[{"code":"0446T","type":"CPT"}],"standard_charges":[{"minimum":121.75,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":121.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL IMPLTBL GLUCOSE SENSOR","code_information":[{"code":"0447T","type":"CPT"}],"standard_charges":[{"minimum":143.04,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REMVL INSJ IMPLTBL GLUC SENS","code_information":[{"code":"0448T","type":"CPT"}],"standard_charges":[{"minimum":203.96,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":203.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"0449","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":356,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":152,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":356,"methodology":"case rate"}]}]},{"description":"INSJ AQUEOUS DRAIN DEV 1ST","code_information":[{"code":"0449T","type":"CPT"}],"standard_charges":[{"minimum":1737.43,"maximum":4244.02,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1737.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ER","code_information":[{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":573,"maximum":573,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ AQUEOUS DRAIN DEV EACH","code_information":[{"code":"0450T","type":"CPT"}],"standard_charges":[{"minimum":727.12,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":727.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0451","type":"APR-DRG"}],"standard_charges":[{"minimum":4659,"maximum":4659,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4659,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4659,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4659,"methodology":"case rate"}]}]},{"description":"ER","code_information":[{"code":"0451","type":"RC"}],"standard_charges":[{"minimum":573,"maximum":573,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0452","type":"APR-DRG"}],"standard_charges":[{"minimum":5856,"maximum":5856,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5856,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5856,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5856,"methodology":"case rate"}]}]},{"description":"ER","code_information":[{"code":"0452","type":"RC"}],"standard_charges":[{"minimum":573,"maximum":573,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0453","type":"APR-DRG"}],"standard_charges":[{"minimum":8461,"maximum":8461,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8461,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8461,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8461,"methodology":"case rate"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0454","type":"APR-DRG"}],"standard_charges":[{"minimum":15248,"maximum":15248,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15248,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15248,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15248,"methodology":"case rate"}]}]},{"description":"URGENT CARE","code_information":[{"code":"0456","type":"RC"}],"standard_charges":[{"minimum":302,"maximum":2931,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2931,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":359,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":302,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":362,"methodology":"case rate"}]}]},{"description":"EMERGENCY ROOM OTHER EMERGENCY ROOM","code_information":[{"code":"0459","type":"RC"}],"standard_charges":[{"minimum":4133,"maximum":4133,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4133,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4133,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EMERGENCY ROOM OTHER EMERGENCY ROOM","code_information":[{"code":"0459","type":"RC"}],"standard_charges":[{"minimum":573,"maximum":4055,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4055,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4055,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":573,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PULMONARY FUNCTION","code_information":[{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":707,"maximum":859,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":839,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":707,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":859,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0461","type":"APR-DRG"}],"standard_charges":[{"minimum":4634,"maximum":4634,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4634,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4634,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4634,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0462","type":"APR-DRG"}],"standard_charges":[{"minimum":5398,"maximum":5398,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5398,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5398,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5398,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0463","type":"APR-DRG"}],"standard_charges":[{"minimum":7119,"maximum":7119,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7119,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7119,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7119,"methodology":"case rate"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0464","type":"APR-DRG"}],"standard_charges":[{"minimum":12779,"maximum":12779,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12779,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12779,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12779,"methodology":"case rate"}]}]},{"description":"VISUAL EP TEST FOR GLAUCOMA","code_information":[{"code":"0464T","type":"CPT"}],"standard_charges":[{"minimum":120.44,"maximum":146.19,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":120.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":120.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":120.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":146.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SUPCHRDL NJX RX W/O SUPPLY","code_information":[{"code":"0465T","type":"CPT"}],"standard_charges":[{"minimum":196.46,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":196.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ CH WAL RESPIR ELTRD/RA","code_information":[{"code":"0466T","type":"CPT"}],"standard_charges":[{"minimum":709.19,"maximum":709.19,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":709.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REVJ/RPLMNT CH RESPIR ELTRD","code_information":[{"code":"0467T","type":"CPT"}],"standard_charges":[{"minimum":543.58,"maximum":543.58,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":543.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL CH WAL RESPIR ELTRD/RA","code_information":[{"code":"0468T","type":"CPT"}],"standard_charges":[{"minimum":487.12,"maximum":487.12,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":487.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PULMONARY FUNCTION","code_information":[{"code":"0469","type":"RC"}],"standard_charges":[{"minimum":707,"maximum":859,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":839,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":707,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":859,"methodology":"case rate"}]}]},{"description":"RTA POLARIZE SCAN OC SCR BI","code_information":[{"code":"0469T","type":"CPT"}],"standard_charges":[{"minimum":103.37,"maximum":103.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUDIOLOGY","code_information":[{"code":"0470","type":"RC"}],"standard_charges":[{"minimum":194,"maximum":233,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":230,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":194,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":233,"methodology":"case rate"}]}]},{"description":"OCT SKN IMG ACQUISJ IR 1ST","code_information":[{"code":"0470T","type":"CPT"}],"standard_charges":[{"minimum":306.06,"maximum":306.06,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":306.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUDIOLOGY","code_information":[{"code":"0471","type":"RC"}],"standard_charges":[{"minimum":194,"maximum":233,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":230,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":194,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":233,"methodology":"case rate"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0471","type":"APR-DRG"}],"standard_charges":[{"minimum":4089,"maximum":4089,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4089,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4089,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4089,"methodology":"case rate"}]}]},{"description":"OCT SKN IMG ACQUISJ IR ADDL","code_information":[{"code":"0471T","type":"CPT"}],"standard_charges":[{"minimum":267.3,"maximum":267.3,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":267.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUDIOLOGY","code_information":[{"code":"0472","type":"RC"}],"standard_charges":[{"minimum":194,"maximum":233,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":230,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":194,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":233,"methodology":"case rate"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0472","type":"APR-DRG"}],"standard_charges":[{"minimum":4530,"maximum":4530,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4530,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4530,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4530,"methodology":"case rate"}]}]},{"description":"PRGRMG IO RTA ELTRD RA","code_information":[{"code":"0472T","type":"CPT"}],"standard_charges":[{"minimum":197.3,"maximum":228.69,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":228.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0473","type":"APR-DRG"}],"standard_charges":[{"minimum":5856,"maximum":5856,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5856,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5856,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5856,"methodology":"case rate"}]}]},{"description":"REPRGRMG IO RTA ELTRD RA","code_information":[{"code":"0473T","type":"CPT"}],"standard_charges":[{"minimum":197.3,"maximum":206.98,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":197.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":206.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0474","type":"APR-DRG"}],"standard_charges":[{"minimum":10823,"maximum":10823,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10823,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10823,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10823,"methodology":"case rate"}]}]},{"description":"INSJ AQUEOUS DRG DEV IO RSVR","code_information":[{"code":"0474T","type":"CPT"}],"standard_charges":[{"minimum":480.77,"maximum":4244.02,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":480.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REC FTL CAR SGL 3 CH IR","code_information":[{"code":"0475T","type":"CPT"}],"standard_charges":[{"minimum":501.07,"maximum":501.07,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":501.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REC FTL CAR SGL ELEC TR DATA","code_information":[{"code":"0476T","type":"CPT"}],"standard_charges":[{"minimum":275.33,"maximum":275.33,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":275.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REC FTL CAR SGL XRTJ ALYS","code_information":[{"code":"0477T","type":"CPT"}],"standard_charges":[{"minimum":246.14,"maximum":246.14,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":246.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REC FTL CAR 3 CH REV IR","code_information":[{"code":"0478T","type":"CPT"}],"standard_charges":[{"minimum":140.21,"maximum":140.21,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":140.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUDIOLOGY","code_information":[{"code":"0479","type":"RC"}],"standard_charges":[{"minimum":194,"maximum":233,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":230,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":194,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":233,"methodology":"case rate"}]}]},{"description":"FXJL ABL LSR 1ST 100 SQ CM","code_information":[{"code":"0479T","type":"CPT"}],"standard_charges":[{"minimum":517.88,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":517.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CARDIOLOGY","code_information":[{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":2963,"maximum":2963,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2963,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"FXJL ABL LSR EA ADDL 100SQCM","code_information":[{"code":"0480T","type":"CPT"}],"standard_charges":[{"minimum":105.42,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":105.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CARDIAC CATH","code_information":[{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":11117,"maximum":11117,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11117,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0481","type":"APR-DRG"}],"standard_charges":[{"minimum":4114,"maximum":4114,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4114,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4114,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4114,"methodology":"case rate"}]}]},{"description":"NJX AUTOL WBC CONCENTRATE","code_information":[{"code":"0481T","type":"CPT"}],"standard_charges":[{"minimum":176.6,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":570.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0482","type":"APR-DRG"}],"standard_charges":[{"minimum":4702,"maximum":4702,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4702,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4702,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4702,"methodology":"case rate"}]}]},{"description":"STRESS TEST","code_information":[{"code":"0482","type":"RC"}],"standard_charges":[{"minimum":1236,"maximum":1236,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1236,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ECHO","code_information":[{"code":"0483","type":"RC"}],"standard_charges":[{"minimum":988,"maximum":988,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":988,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0483","type":"APR-DRG"}],"standard_charges":[{"minimum":6758,"maximum":6758,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6758,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6758,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6758,"methodology":"case rate"}]}]},{"description":"TMVI PERCUTANEOUS APPROACH","code_information":[{"code":"0483T","type":"CPT"}],"standard_charges":[{"minimum":3152.27,"maximum":15367.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3152.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0484","type":"APR-DRG"}],"standard_charges":[{"minimum":13912,"maximum":13912,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13912,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13912,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13912,"methodology":"case rate"}]}]},{"description":"TMVI TRANSTHORACIC EXPOSURE","code_information":[{"code":"0484T","type":"CPT"}],"standard_charges":[{"minimum":4137.63,"maximum":15367.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15367.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4137.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OCT MID EAR IR UNILATERAL","code_information":[{"code":"0485T","type":"CPT"}],"standard_charges":[{"minimum":59.97,"maximum":254.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":254.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":254.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":254.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":59.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OCT MID EAR IR BILATERAL","code_information":[{"code":"0486T","type":"CPT"}],"standard_charges":[{"minimum":204.42,"maximum":254.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":254.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":254.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":254.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":204.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRVG BIOMCHN MAPG W/REPRT","code_information":[{"code":"0487T","type":"CPT"}],"standard_charges":[{"minimum":244.53,"maximum":244.53,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":244.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DIABETES PREV ONLINE/ELEC","code_information":[{"code":"0488T","type":"CPT"}],"standard_charges":[{"minimum":123.02,"maximum":442.28,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":442.28,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":442.28,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":442.28,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":123.02,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CARDIOLOGY","code_information":[{"code":"0489","type":"RC"}],"standard_charges":[{"minimum":2963,"maximum":2963,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2963,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REGN CELL TX SCLDR HANDS","code_information":[{"code":"0489T","type":"CPT"}],"standard_charges":[{"minimum":366.45,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":366.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REGN CELL TX SCLDR H MLT INJ","code_information":[{"code":"0490T","type":"CPT"}],"standard_charges":[{"minimum":208.95,"maximum":1203.42,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1203.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0491","type":"APR-DRG"}],"standard_charges":[{"minimum":5562,"maximum":5562,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5562,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5562,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5562,"methodology":"case rate"}]}]},{"description":"ABL LSR OPN WND 1ST 20 SQCM","code_information":[{"code":"0491T","type":"CPT"}],"standard_charges":[{"minimum":261.45,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":261.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0492","type":"APR-DRG"}],"standard_charges":[{"minimum":12079,"maximum":12079,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12079,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12079,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12079,"methodology":"case rate"}]}]},{"description":"ABL LSR OPN WND ADDL 20 SQCM","code_information":[{"code":"0492T","type":"CPT"}],"standard_charges":[{"minimum":195.36,"maximum":195.36,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":195.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0493","type":"APR-DRG"}],"standard_charges":[{"minimum":15971,"maximum":15971,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15971,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15971,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15971,"methodology":"case rate"}]}]},{"description":"NEAR IFR SPECTRSC OF WOUNDS","code_information":[{"code":"0493T","type":"CPT"}],"standard_charges":[{"minimum":83.56,"maximum":83.56,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":83.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0494","type":"APR-DRG"}],"standard_charges":[{"minimum":25791,"maximum":25791,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25791,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25791,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25791,"methodology":"case rate"}]}]},{"description":"PREP  CANNULJ CDVR DON LUNG","code_information":[{"code":"0494T","type":"CPT"}],"standard_charges":[{"minimum":691,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":691,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MNTR CDVR DON LNG 1ST 2 HRS","code_information":[{"code":"0495T","type":"CPT"}],"standard_charges":[{"minimum":699.58,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":699.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MNTR CDVR DON LNG EA ADDL HR","code_information":[{"code":"0496T","type":"CPT"}],"standard_charges":[{"minimum":547.84,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":547.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"XTRNL PT ACT ECG IN-OFF CONN","code_information":[{"code":"0497T","type":"CPT"}],"standard_charges":[{"minimum":456.59,"maximum":456.59,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":456.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"XTRNL PT ACT ECG RI PR 30 D","code_information":[{"code":"0498T","type":"CPT"}],"standard_charges":[{"minimum":59.36,"maximum":59.36,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":59.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYSTO F/URTL STRIX/STENOSIS","code_information":[{"code":"0499T","type":"CPT"}],"standard_charges":[{"minimum":209,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":209,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INITIAL PRENATAL CARE VISIT","code_information":[{"code":"0500F","type":"CPT"}],"standard_charges":[{"minimum":329.86,"maximum":329.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":329.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":329.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":329.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HPV 5+ HI RISK HPV TYPES","code_information":[{"code":"0500T","type":"CPT"}],"standard_charges":[{"minimum":128.43,"maximum":128.43,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":128.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":128.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":128.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0501","type":"APR-DRG"}],"standard_charges":[{"minimum":4206,"maximum":4206,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4206,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4206,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4206,"methodology":"case rate"}]}]},{"description":"PRENATAL FLOW SHEET","code_information":[{"code":"0501F","type":"CPT"}],"standard_charges":[{"minimum":329.86,"maximum":329.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":329.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":329.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":329.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"COR FFR DERIVED COR CTA DATA","code_information":[{"code":"0501T","type":"CPT"}],"standard_charges":[{"minimum":281.5,"maximum":2162.71,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":281.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":281.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":281.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2162.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0502","type":"APR-DRG"}],"standard_charges":[{"minimum":7623,"maximum":7623,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7623,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7623,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7623,"methodology":"case rate"}]}]},{"description":"SUBSEQUENT PRENATAL CARE","code_information":[{"code":"0502F","type":"CPT"}],"standard_charges":[{"minimum":109.94,"maximum":109.94,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT FFR DATA ANGIO PREP TRANSM","code_information":[{"code":"0502T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":3490.05,"maximum":5379.945,"gross_charge":6585,"discounted_cash":2634,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3490.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":5379.95,"methodology":"fee schedule"}]}]},{"description":"CT FFR DATA ANGIO PREP TRANSM","code_information":[{"code":"0502T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":3490.05,"maximum":5379.945,"gross_charge":6585,"discounted_cash":2634,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3490.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":5379.95,"methodology":"fee schedule"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0503","type":"APR-DRG"}],"standard_charges":[{"minimum":13331,"maximum":13331,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13331,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13331,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13331,"methodology":"case rate"}]}]},{"description":"POSTPARTUM CARE VISIT","code_information":[{"code":"0503F","type":"CPT"}],"standard_charges":[{"minimum":109.94,"maximum":109.94,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT FFR ANALYZE FLUID DYNAMICS","code_information":[{"code":"0503T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":3490.05,"maximum":5379.945,"gross_charge":6585,"discounted_cash":2634,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3490.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":5379.95,"methodology":"fee schedule"}]}]},{"description":"CT FFR ANALYZE FLUID DYNAMICS","code_information":[{"code":"0503T","type":"CPT"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":956.64,"maximum":5379.945,"gross_charge":6585,"discounted_cash":2634,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3490.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":5379.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":956.64,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":966.21,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":985.34,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":975.78,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":956.64,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":956.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":956.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":966.21,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":956.64,"methodology":"fee schedule"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0504","type":"APR-DRG"}],"standard_charges":[{"minimum":27028,"maximum":27028,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":27028,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":27028,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":27028,"methodology":"case rate"}]}]},{"description":"COR FFR DATA REVIEW IR","code_information":[{"code":"0504T","type":"CPT"}],"standard_charges":[{"minimum":157.94,"maximum":281.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":281.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":281.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":281.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":157.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EV FEMPOP ARTL REVSC","code_information":[{"code":"0505T","type":"CPT"}],"standard_charges":[{"minimum":2003.3,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2003.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAC PGMT OPT DNS MEAS HFP","code_information":[{"code":"0506T","type":"CPT"}],"standard_charges":[{"minimum":103.37,"maximum":284.39,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":284.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NEAR IFR 2IMG MIBMN GLND IR","code_information":[{"code":"0507T","type":"CPT"}],"standard_charges":[{"minimum":64.57,"maximum":132.06,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":132.06,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":132.06,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":64.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PLS ECHO US B1 DNS MEAS TIB","code_information":[{"code":"0508T","type":"CPT"}],"standard_charges":[{"minimum":14.1,"maximum":332.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14.1,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":332.91,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":332.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":30.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PATTERN ERG W/IR","code_information":[{"code":"0509T","type":"CPT"}],"standard_charges":[{"minimum":162.47,"maximum":261.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":162.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLINIC VISIT","code_information":[{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":75,"maximum":75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL SINUS TARSI IMPLANT","code_information":[{"code":"0510T","type":"CPT"}],"standard_charges":[{"minimum":810.19,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":810.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLINIC VISIT","code_information":[{"code":"0511","type":"RC"}],"standard_charges":[{"minimum":75,"maximum":75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0511","type":"APR-DRG"}],"standard_charges":[{"minimum":2998,"maximum":2998,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2998,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2998,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2998,"methodology":"case rate"}]}]},{"description":"RMVLRINSJ SINUS TARSI IMPLT","code_information":[{"code":"0511T","type":"CPT"}],"standard_charges":[{"minimum":1045.81,"maximum":4534.34,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4534.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4534.34,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4534.34,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1045.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLINIC VISIT","code_information":[{"code":"0512","type":"RC"}],"standard_charges":[{"minimum":75,"maximum":75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0512","type":"APR-DRG"}],"standard_charges":[{"minimum":4519,"maximum":4519,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4519,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4519,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4519,"methodology":"case rate"}]}]},{"description":"ESW INTEG WND HLG 1ST WND","code_information":[{"code":"0512T","type":"CPT"}],"standard_charges":[{"minimum":36.06,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1867.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1867.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1867.98,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":36.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLINIC VISIT","code_information":[{"code":"0513","type":"RC"}],"standard_charges":[{"minimum":75,"maximum":75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0513","type":"APR-DRG"}],"standard_charges":[{"minimum":8511,"maximum":8511,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8511,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8511,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8511,"methodology":"case rate"}]}]},{"description":"ESW INTEG WND HLG EA ADDL","code_information":[{"code":"0513T","type":"CPT"}],"standard_charges":[{"minimum":25.12,"maximum":932.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":932.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":932.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":932.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":25.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLINIC VISIT","code_information":[{"code":"0514","type":"RC"}],"standard_charges":[{"minimum":75,"maximum":75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0514","type":"APR-DRG"}],"standard_charges":[{"minimum":14764,"maximum":14764,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14764,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14764,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14764,"methodology":"case rate"}]}]},{"description":"INTRAOP VIS AXIS ID PT FIXJ","code_information":[{"code":"0514T","type":"CPT"}],"standard_charges":[{"minimum":480.24,"maximum":480.24,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":480.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLINIC VISIT","code_information":[{"code":"0515","type":"RC"}],"standard_charges":[{"minimum":75,"maximum":75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ WCS LV COMPL SYS","code_information":[{"code":"0515T","type":"CPT"}],"standard_charges":[{"minimum":1040.8,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1040.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLINIC VISIT","code_information":[{"code":"0516","type":"RC"}],"standard_charges":[{"minimum":75,"maximum":75,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ WCS LV ELTRD ONLY","code_information":[{"code":"0516T","type":"CPT"}],"standard_charges":[{"minimum":869.46,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":869.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ WCS LV PG COMPNT","code_information":[{"code":"0517T","type":"CPT"}],"standard_charges":[{"minimum":732.16,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":732.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL PG COMPNT WCS","code_information":[{"code":"0518T","type":"CPT"}],"standard_charges":[{"minimum":513.17,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":513.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVL  RPLCMT PG COMPNT WCS","code_information":[{"code":"0519T","type":"CPT"}],"standard_charges":[{"minimum":1649.36,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1649.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL DISORDERS AND INJURIES WITH CC/MCC","code_information":[{"code":"052","type":"MS-DRG"}],"standard_charges":[{"minimum":24006.96,"maximum":46447.8,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32008.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":24006.96,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":24006.96,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27606.07,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":27606.07,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":28366.37,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37478,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":42921,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":27810,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":45094.95,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":45545.9,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":46447.8,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45996.85,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":45094.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":45094.95,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":45094.95,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":45545.9,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":45094.95,"methodology":"case rate"}]}]},{"description":"RMVLRPLCMT PG WCS NEW ELTRD","code_information":[{"code":"0520T","type":"CPT"}],"standard_charges":[{"minimum":1127.5,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1127.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0521","type":"APR-DRG"}],"standard_charges":[{"minimum":3828,"maximum":3828,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3828,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3828,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3828,"methodology":"case rate"}]}]},{"description":"INTERROG DEV EVAL WCS IP","code_information":[{"code":"0521T","type":"CPT"}],"standard_charges":[{"minimum":107.84,"maximum":109.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":109.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":109.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":107.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0522","type":"APR-DRG"}],"standard_charges":[{"minimum":4301,"maximum":4301,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4301,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4301,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4301,"methodology":"case rate"}]}]},{"description":"PRGRMG DEV EVAL WCS IP","code_information":[{"code":"0522T","type":"CPT"}],"standard_charges":[{"minimum":109.14,"maximum":149.09,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":109.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":109.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":149.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0523","type":"APR-DRG"}],"standard_charges":[{"minimum":5549,"maximum":5549,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5549,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5549,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5549,"methodology":"case rate"}]}]},{"description":"NTRAPX C FFR W/3D FUNCJL MAP","code_information":[{"code":"0523T","type":"CPT"}],"standard_charges":[{"minimum":140.77,"maximum":252.58,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":140.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":140.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":140.77,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0524","type":"APR-DRG"}],"standard_charges":[{"minimum":13003,"maximum":13003,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13003,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13003,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13003,"methodology":"case rate"}]}]},{"description":"EV CATH DIR CHEM ABLTJ W/IMG","code_information":[{"code":"0524T","type":"CPT"}],"standard_charges":[{"minimum":898.12,"maximum":2471.06,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":898.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":898.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":898.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2471.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLCMT COMPL IIMS","code_information":[{"code":"0525T","type":"CPT"}],"standard_charges":[{"minimum":925.45,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":925.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLCMT IIMS ELTRD ONLY","code_information":[{"code":"0526T","type":"CPT"}],"standard_charges":[{"minimum":1743.3,"maximum":2945.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1743.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ/RPLCMT IIMS IMPLT MNTR","code_information":[{"code":"0527T","type":"CPT"}],"standard_charges":[{"minimum":739.13,"maximum":2945.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":739.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PRGRMG DEV EVAL IIMS IP","code_information":[{"code":"0528T","type":"CPT"}],"standard_charges":[{"minimum":55.43,"maximum":150.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":150.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTERROG DEV EVAL IIMS IP","code_information":[{"code":"0529T","type":"CPT"}],"standard_charges":[{"minimum":55.43,"maximum":107.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":55.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":107.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC","code_information":[{"code":"053","type":"MS-DRG"}],"standard_charges":[{"minimum":13967.01,"maximum":39208.2,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24954.53,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18716.48,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18716.48,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13967.01,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":13967.01,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14351.67,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18962,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":21715,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14070,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38066.21,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38446.88,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39208.2,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38827.54,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38066.21,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38066.21,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38066.21,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38446.88,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38066.21,"methodology":"case rate"}]}]},{"description":"REMOVAL COMPLETE IIMS","code_information":[{"code":"0530T","type":"CPT"}],"standard_charges":[{"minimum":483.54,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":483.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SEIZURE","code_information":[{"code":"0531","type":"APR-DRG"}],"standard_charges":[{"minimum":3514,"maximum":3514,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3514,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3514,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3514,"methodology":"case rate"}]}]},{"description":"REMOVAL IIMS ELECTRODE ONLY","code_information":[{"code":"0531T","type":"CPT"}],"standard_charges":[{"minimum":1100.07,"maximum":1474.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1474.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1474.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1474.52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SEIZURE","code_information":[{"code":"0532","type":"APR-DRG"}],"standard_charges":[{"minimum":4288,"maximum":4288,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4288,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4288,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4288,"methodology":"case rate"}]}]},{"description":"REMOVAL IIMS IMPLT MNTR ONLY","code_information":[{"code":"0532T","type":"CPT"}],"standard_charges":[{"minimum":1206.99,"maximum":1474.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1474.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1474.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1474.52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1206.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SEIZURE","code_information":[{"code":"0533","type":"APR-DRG"}],"standard_charges":[{"minimum":5666,"maximum":5666,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5666,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5666,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5666,"methodology":"case rate"}]}]},{"description":"CONT REC MVMT DO 6-10 DAYS","code_information":[{"code":"0533T","type":"CPT"}],"standard_charges":[{"minimum":321.29,"maximum":457.45,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":457.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":457.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":457.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":321.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SEIZURE","code_information":[{"code":"0534","type":"APR-DRG"}],"standard_charges":[{"minimum":14151,"maximum":14151,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14151,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14151,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14151,"methodology":"case rate"}]}]},{"description":"CONT REC MVMT DO SETUPTRAIN","code_information":[{"code":"0534T","type":"CPT"}],"standard_charges":[{"minimum":100.58,"maximum":132.78,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":132.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":132.78,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":100.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CONT REC MVMT DO REPRT CNFIG","code_information":[{"code":"0535T","type":"CPT"}],"standard_charges":[{"minimum":115.76,"maximum":189.55,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":189.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":189.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":189.55,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":115.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CONT REC MVMT DO DL W/IR","code_information":[{"code":"0536T","type":"CPT"}],"standard_charges":[{"minimum":135.15,"maximum":135.15,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":135.15,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":135.15,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":135.15,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLD DRV T LYMPHCYT CAR-T CLL","code_information":[{"code":"0537T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BLD DRV T LYMPHCYT PREP TRNS","code_information":[{"code":"0538T","type":"CPT"}],"standard_charges":[{"minimum":41.29,"maximum":41.29,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":41.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":41.29,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RECEIPTPREP CAR-T CLL ADMN","code_information":[{"code":"0539T","type":"CPT"}],"standard_charges":[{"minimum":39.38,"maximum":39.38,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":39.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":39.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NERVOUS SYSTEM NEOPLASMS WITH MCC","code_information":[{"code":"054","type":"MS-DRG"}],"standard_charges":[{"minimum":20919.28,"maximum":42898.46,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27931.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":20948.96,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":20948.96,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20919.28,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20919.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":21495.42,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28400,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":32525,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21074,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41648.99,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42065.48,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42898.46,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42481.97,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41648.99,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41648.99,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41648.99,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42065.48,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41648.99,"methodology":"case rate"}]}]},{"description":"CAR-T CLL ADMN AUTOLOGOUS","code_information":[{"code":"0540T","type":"CPT"}],"standard_charges":[{"minimum":364.17,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":364.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0541","type":"APR-DRG"}],"standard_charges":[{"minimum":3786,"maximum":3786,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3786,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3786,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3786,"methodology":"case rate"}]}]},{"description":"MYOCARDIAL IMAGING MCG","code_information":[{"code":"0541T","type":"CPT"}],"standard_charges":[{"minimum":699.78,"maximum":1235.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1235.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1235.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1235.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":699.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0542","type":"APR-DRG"}],"standard_charges":[{"minimum":4449,"maximum":4449,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4449,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4449,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4449,"methodology":"case rate"}]}]},{"description":"MYOCARDIAL IMAGING MCG IR","code_information":[{"code":"0542T","type":"CPT"}],"standard_charges":[{"minimum":33.97,"maximum":1235.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1235.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1235.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1235.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":33.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0543","type":"APR-DRG"}],"standard_charges":[{"minimum":5488,"maximum":5488,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5488,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5488,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5488,"methodology":"case rate"}]}]},{"description":"TA MV RPR W/ARTIF CHORD TEND","code_information":[{"code":"0543T","type":"CPT"}],"standard_charges":[{"minimum":3826.24,"maximum":24619.9,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24619.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":24619.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":24619.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3826.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0544","type":"APR-DRG"}],"standard_charges":[{"minimum":10322,"maximum":10322,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10322,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10322,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10322,"methodology":"case rate"}]}]},{"description":"TCAT MV ANNULUS RCNSTJ","code_information":[{"code":"0544T","type":"CPT"}],"standard_charges":[{"minimum":3194.51,"maximum":24619.9,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24619.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":24619.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":24619.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3194.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TCAT TV ANNULUS RCNSTJ","code_information":[{"code":"0545T","type":"CPT"}],"standard_charges":[{"minimum":3892.33,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3892.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RF SPECTRSC NTRAOP MRGN ASMT","code_information":[{"code":"0546T","type":"CPT"}],"standard_charges":[{"minimum":243.87,"maximum":1538.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1538.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1538.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1538.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":243.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"B1 MATRL QUAL TST MCRIND TIB","code_information":[{"code":"0547T","type":"CPT"}],"standard_charges":[{"minimum":15.43,"maximum":296.65,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15.43,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":296.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TPRNL BALO CNTNC DEV BI","code_information":[{"code":"0548T","type":"CPT"}],"standard_charges":[{"minimum":576.62,"maximum":576.62,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":576.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NERVOUS SYSTEM NEOPLASMS WITHOUT MCC","code_information":[{"code":"055","type":"MS-DRG"}],"standard_charges":[{"minimum":15236.22,"maximum":39881.89,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22013.07,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16510.32,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16510.32,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15236.22,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":15236.22,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":15655.84,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20685,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":23689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":15349,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38720.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39107.49,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39881.89,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39494.69,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38720.28,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38720.28,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38720.28,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39107.49,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38720.28,"methodology":"case rate"}]}]},{"description":"TPRNL BALO CNTNC DEV RMVL EA","code_information":[{"code":"0550T","type":"CPT"}],"standard_charges":[{"minimum":61.01,"maximum":61.01,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":61.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0551","type":"APR-DRG"}],"standard_charges":[{"minimum":4563,"maximum":4563,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4563,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4563,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4563,"methodology":"case rate"}]}]},{"description":"TPRNL BALO CNTNC DEV ADJMT","code_information":[{"code":"0551T","type":"CPT"}],"standard_charges":[{"minimum":86.83,"maximum":86.83,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":86.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0552","type":"APR-DRG"}],"standard_charges":[{"minimum":6207,"maximum":6207,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6207,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6207,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6207,"methodology":"case rate"}]}]},{"description":"LOW-LEVEL LASER THERAPY","code_information":[{"code":"0552T","type":"CPT"}],"standard_charges":[{"minimum":14.34,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0553","type":"APR-DRG"}],"standard_charges":[{"minimum":9436,"maximum":9436,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9436,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9436,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9436,"methodology":"case rate"}]}]},{"description":"PERQ TCAT ILIAC ANAST IMPLT","code_information":[{"code":"0553T","type":"CPT"}],"standard_charges":[{"minimum":3414.25,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3414.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0554","type":"APR-DRG"}],"standard_charges":[{"minimum":19084,"maximum":19084,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":19084,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":19084,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":19084,"methodology":"case rate"}]}]},{"description":"B1 STR  FX RSK ANALYSIS","code_information":[{"code":"0554T","type":"CPT"}],"standard_charges":[{"minimum":95.5,"maximum":425.59,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":425.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":425.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":425.59,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":95.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"B1 STRFX RSK TRANSMIS DATA","code_information":[{"code":"0555T","type":"CPT"}],"standard_charges":[{"minimum":37.62,"maximum":155.13,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.29,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":68.29,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"B1 STR  FX RSK ASSESSMENT","code_information":[{"code":"0556T","type":"CPT"}],"standard_charges":[{"minimum":74.51,"maximum":692.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":692.2,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":692.2,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":74.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"B1 STR  FX RSK IR","code_information":[{"code":"0557T","type":"CPT"}],"standard_charges":[{"minimum":37.62,"maximum":155.13,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":155.13,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT SCAN F/BIOMCHN CT ALYS","code_information":[{"code":"0558T","type":"CPT"}],"standard_charges":[{"minimum":259.45,"maximum":428.41,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":259.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":259.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":259.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":428.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANTMC MDL 3D PRINT 1ST CMPNT","code_information":[{"code":"0559T","type":"CPT"}],"standard_charges":[{"minimum":31.06,"maximum":43.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":43.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":43.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":31.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC","code_information":[{"code":"056","type":"MS-DRG"}],"standard_charges":[{"minimum":18544.2,"maximum":52843,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24724.83,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18544.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18544.2,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33987.62,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":33987.62,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":34923.67,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46142,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":52843,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":34239,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":48383.62,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":48867.46,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":49835.13,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":49351.3,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":48383.62,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":48383.62,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":48383.62,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":48867.46,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":48383.62,"methodology":"case rate"}]}]},{"description":"ANTMC MDL 3D PRINT EA ADDL","code_information":[{"code":"0560T","type":"CPT"}],"standard_charges":[{"minimum":5.5,"maximum":23.17,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":23.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0561","type":"APR-DRG"}],"standard_charges":[{"minimum":4139,"maximum":4139,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4139,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4139,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4139,"methodology":"case rate"}]}]},{"description":"ANTMC GUIDE 3D PRINT 1ST GD","code_information":[{"code":"0561T","type":"CPT"}],"standard_charges":[{"minimum":43.89,"maximum":149.09,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":43.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":43.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":149.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0562","type":"APR-DRG"}],"standard_charges":[{"minimum":5956,"maximum":5956,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5956,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5956,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5956,"methodology":"case rate"}]}]},{"description":"ANTMC GUIDE 3D PRINT EA ADDL","code_information":[{"code":"0562T","type":"CPT"}],"standard_charges":[{"minimum":5.5,"maximum":41.98,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":41.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0563","type":"APR-DRG"}],"standard_charges":[{"minimum":9496,"maximum":9496,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9496,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9496,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9496,"methodology":"case rate"}]}]},{"description":"EVAC MEIBOMIAN GLND HEAT BI","code_information":[{"code":"0563T","type":"CPT"}],"standard_charges":[{"minimum":34.19,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1725.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1725.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1725.69,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":34.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0564","type":"APR-DRG"}],"standard_charges":[{"minimum":17802,"maximum":17802,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17802,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17802,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17802,"methodology":"case rate"}]}]},{"description":"ONC CHEMO RX CYTOTOX CSC 14","code_information":[{"code":"0564T","type":"CPT"}],"standard_charges":[{"minimum":66.04,"maximum":1376.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1376.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1376.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1376.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":160.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":160.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":66.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOL CELL IMPLT ADPS HRVG","code_information":[{"code":"0565T","type":"CPT"}],"standard_charges":[{"minimum":292.6,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTOL CELL IMPLT ADPS NJX","code_information":[{"code":"0566T","type":"CPT"}],"standard_charges":[{"minimum":59.4,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":59.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERM FLP TUBE OCCLS W/IMPLT","code_information":[{"code":"0567T","type":"CPT"}],"standard_charges":[{"minimum":568.77,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":568.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRO MIX SALINEAIR F/SSG","code_information":[{"code":"0568T","type":"CPT"}],"standard_charges":[{"minimum":63.8,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":270.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":270.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":270.84,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":63.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TTVR PERQ APPR 1ST PROSTH","code_information":[{"code":"0569T","type":"CPT"}],"standard_charges":[{"minimum":2055.72,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2055.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC","code_information":[{"code":"057","type":"MS-DRG"}],"standard_charges":[{"minimum":12947.44,"maximum":42067.26,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17262.71,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12947.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12947.44,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19353.35,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":19353.35,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19886.36,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":30090,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":19496,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40842,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":41250.42,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42067.26,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41658.84,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40842,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40842,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40842,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":41250.42,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40842,"methodology":"case rate"}]}]},{"description":"TTVR PERQ EA ADDL PROSTH","code_information":[{"code":"0570T","type":"CPT"}],"standard_charges":[{"minimum":1028.24,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1028.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0571","type":"APR-DRG"}],"standard_charges":[{"minimum":4136,"maximum":4136,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4136,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4136,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4136,"methodology":"case rate"}]}]},{"description":"INSJ/RPLCMT ICDS SS ELTRD","code_information":[{"code":"0571T","type":"CPT"}],"standard_charges":[{"minimum":378.4,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":378.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0572","type":"APR-DRG"}],"standard_charges":[{"minimum":5712,"maximum":5712,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5712,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5712,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5712,"methodology":"case rate"}]}]},{"description":"INSERTION SS DFB ELECTRODE","code_information":[{"code":"0572T","type":"CPT"}],"standard_charges":[{"minimum":308,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0573","type":"APR-DRG"}],"standard_charges":[{"minimum":7979,"maximum":7979,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7979,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7979,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7979,"methodology":"case rate"}]}]},{"description":"REMOVAL SS DFB ELECTRODE","code_information":[{"code":"0573T","type":"CPT"}],"standard_charges":[{"minimum":231,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":231,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CONCUSSION, CLOSED SKULL FRACTURE NOS, AND UNCOMPLICATED INTRACRANIAL INJURY, COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0574","type":"APR-DRG"}],"standard_charges":[{"minimum":15397,"maximum":15397,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15397,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15397,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15397,"methodology":"case rate"}]}]},{"description":"REPOS PREV SS IMPL DFB ELTRD","code_information":[{"code":"0574T","type":"CPT"}],"standard_charges":[{"minimum":270.6,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":270.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PRGRMG DEV EVAL ICDS SS IP","code_information":[{"code":"0575T","type":"CPT"}],"standard_charges":[{"minimum":142.03,"maximum":169.33,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":142.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":142.03,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":169.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTERROG DEV EVAL ICDS SS IP","code_information":[{"code":"0576T","type":"CPT"}],"standard_charges":[{"minimum":39.6,"maximum":68.61,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":68.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":68.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":39.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EPHYS EVAL ICDS SS","code_information":[{"code":"0577T","type":"CPT"}],"standard_charges":[{"minimum":149.6,"maximum":1512.72,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":149.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REM INTERROG DEV ICDS PHYS","code_information":[{"code":"0578T","type":"CPT"}],"standard_charges":[{"minimum":88.11,"maximum":355.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":355.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":355.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":355.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":88.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REM INTERROG DEV ICDS TECH","code_information":[{"code":"0579T","type":"CPT"}],"standard_charges":[{"minimum":58.41,"maximum":189.89,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":189.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":189.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":189.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":58.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC","code_information":[{"code":"058","type":"MS-DRG"}],"standard_charges":[{"minimum":20032.52,"maximum":44815.56,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26709.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":20032.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":20032.52,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24531,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24531,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":25206.61,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33304,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":38140,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":24712,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43510.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":43945.36,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":44815.56,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44380.46,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43510.25,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43510.25,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43510.25,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":43945.36,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43510.25,"methodology":"case rate"}]}]},{"description":"RMVL SS IMPL DFB PG ONLY","code_information":[{"code":"0580T","type":"CPT"}],"standard_charges":[{"minimum":143,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":143,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0581","type":"APR-DRG"}],"standard_charges":[{"minimum":5303,"maximum":5303,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5303,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5303,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5303,"methodology":"case rate"}]}]},{"description":"ABLTJ MAL BRST TUM PERQ CRTX","code_information":[{"code":"0581T","type":"CPT"}],"standard_charges":[{"minimum":1302.4,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1302.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0582","type":"APR-DRG"}],"standard_charges":[{"minimum":7102,"maximum":7102,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7102,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7102,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7102,"methodology":"case rate"}]}]},{"description":"TRURL ABLTJ MAL PRST8 TISS","code_information":[{"code":"0582T","type":"CPT"}],"standard_charges":[{"minimum":908.6,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":908.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0583","type":"APR-DRG"}],"standard_charges":[{"minimum":9213,"maximum":9213,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9213,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9213,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9213,"methodology":"case rate"}]}]},{"description":"TMPST AUTO TUBE DLVR SYS","code_information":[{"code":"0583T","type":"CPT"}],"standard_charges":[{"minimum":125.4,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":125.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0584","type":"APR-DRG"}],"standard_charges":[{"minimum":13686,"maximum":13686,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13686,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13686,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13686,"methodology":"case rate"}]}]},{"description":"PERQ ISLET CELL TRANSPLANT","code_information":[{"code":"0584T","type":"CPT"}],"standard_charges":[{"minimum":180.4,"maximum":4244.02,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":180.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LAPS ISLET CELL TRANSPLANT","code_information":[{"code":"0585T","type":"CPT"}],"standard_charges":[{"minimum":885.37,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":885.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OPEN ISLET CELL TRANSPLANT","code_information":[{"code":"0586T","type":"CPT"}],"standard_charges":[{"minimum":944.64,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":944.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ IMPLTJ/RPLCMT ISDNS PTN","code_information":[{"code":"0587T","type":"CPT"}],"standard_charges":[{"minimum":180.4,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":180.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REVISION/REMOVAL ISDNS PTN","code_information":[{"code":"0588T","type":"CPT"}],"standard_charges":[{"minimum":132,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":132,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ELEC ALYS SMPL PRGRMG IINS","code_information":[{"code":"0589T","type":"CPT"}],"standard_charges":[{"minimum":55,"maximum":183.51,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":183.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":183.51,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":183.51,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC","code_information":[{"code":"059","type":"MS-DRG"}],"standard_charges":[{"minimum":14586.51,"maximum":40740.98,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19448.07,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14586.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14586.51,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16854.68,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":16854.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17318.87,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22882,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":26205,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":16979,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39554.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39949.89,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40740.98,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40345.43,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39554.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39554.34,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39554.34,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39949.89,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39554.34,"methodology":"case rate"}]}]},{"description":"ELEC ALYS CPLX PRGRMG IINS","code_information":[{"code":"0590T","type":"CPT"}],"standard_charges":[{"minimum":35.2,"maximum":244.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":244.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":35.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0591","type":"APR-DRG"}],"standard_charges":[{"minimum":4053,"maximum":4053,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4053,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4053,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4053,"methodology":"case rate"}]}]},{"description":"HLTHWB COACHING INDIV 1ST","code_information":[{"code":"0591T","type":"CPT"}],"standard_charges":[{"minimum":66,"maximum":110.13,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":110.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":110.13,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0592","type":"APR-DRG"}],"standard_charges":[{"minimum":6416,"maximum":6416,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6416,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6416,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6416,"methodology":"case rate"}]}]},{"description":"HLTHWB COACHING INDIV F-UP","code_information":[{"code":"0592T","type":"CPT"}],"standard_charges":[{"minimum":66,"maximum":106.54,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":106.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":106.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":106.54,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0593","type":"APR-DRG"}],"standard_charges":[{"minimum":9361,"maximum":9361,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9361,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9361,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9361,"methodology":"case rate"}]}]},{"description":"HLTHWB COACHING GROUP","code_information":[{"code":"0593T","type":"CPT"}],"standard_charges":[{"minimum":22.84,"maximum":66,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":22.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":22.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0594","type":"APR-DRG"}],"standard_charges":[{"minimum":14622,"maximum":14622,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14622,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14622,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14622,"methodology":"case rate"}]}]},{"description":"OSTEOT HUM XTRNL LNGTH DEV","code_information":[{"code":"0594T","type":"CPT"}],"standard_charges":[{"minimum":2586.69,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2586.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TEMP FML IU VLV-PMP 1ST INSJ","code_information":[{"code":"0596T","type":"CPT"}],"standard_charges":[{"minimum":179.37,"maximum":2262,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":721.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":721.71,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":721.71,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":179.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TEMP FML IU VALVE-PMP RPLCMT","code_information":[{"code":"0597T","type":"CPT"}],"standard_charges":[{"minimum":54.58,"maximum":2262,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":373.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":373.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":373.94,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":54.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NCNTC R-T FLUOR WND IMG 1ST","code_information":[{"code":"0598T","type":"CPT"}],"standard_charges":[{"minimum":16.5,"maximum":376.61,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":376.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":376.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":376.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NCNTC R-T FLUOR WND IMG EA","code_information":[{"code":"0599T","type":"CPT"}],"standard_charges":[{"minimum":16.5,"maximum":376.61,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":376.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":376.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":376.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC","code_information":[{"code":"060","type":"MS-DRG"}],"standard_charges":[{"minimum":12740.39,"maximum":38557.11,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17202.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12901.98,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12901.98,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12740.39,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12740.39,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13091.27,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17296,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":19808,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":12835,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37434.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37808.43,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38557.11,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38182.77,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37434.08,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37434.08,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37434.08,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37808.43,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37434.08,"methodology":"case rate"}]}]},{"description":"IRE ABLTJ 1+TUM ORGAN PERQ","code_information":[{"code":"0600T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":3838.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3838.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IRE ABLTJ 1+TUMORS OPEN","code_information":[{"code":"0601T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":3242.27,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3242.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRANSDERMAL GFR MEASUREMENTS","code_information":[{"code":"0602T","type":"CPT"}],"standard_charges":[{"minimum":417.58,"maximum":514.9,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":514.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":514.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":514.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":417.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRANSDERMAL GFR MONITORING","code_information":[{"code":"0603T","type":"CPT"}],"standard_charges":[{"minimum":514.9,"maximum":1054.31,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":514.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":514.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":514.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1054.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REM OCT RTA DEV SETUPEDUCAJ","code_information":[{"code":"0604T","type":"CPT"}],"standard_charges":[{"minimum":39.8,"maximum":103.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":39.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REM OCT RTA TECHL SPRT MIN 8","code_information":[{"code":"0605T","type":"CPT"}],"standard_charges":[{"minimum":137.52,"maximum":361.09,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":137.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":137.52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":361.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REM OCT RTA PHYS/QHP EA 30D","code_information":[{"code":"0606T","type":"CPT"}],"standard_charges":[{"minimum":60.06,"maximum":137.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":137.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":137.52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":60.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REM MNTR PULM FLU MNTR SETUP","code_information":[{"code":"0607T","type":"CPT"}],"standard_charges":[{"minimum":53.53,"maximum":181.03,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":53.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REM MNTR PULM FLU MNTR ALYS","code_information":[{"code":"0608T","type":"CPT"}],"standard_charges":[{"minimum":181.03,"maximum":534.78,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":534.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MRS DISC PAIN ACQUISJ DATA","code_information":[{"code":"0609T","type":"CPT"}],"standard_charges":[{"minimum":500.48,"maximum":1439.38,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":500.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC","code_information":[{"code":"061","type":"MS-DRG"}],"standard_charges":[{"minimum":39791.35,"maximum":61866,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57693.39,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":43271.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":43271.4,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39791.35,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":39791.35,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":40887.25,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54021,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":61866,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":40086,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":51374.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":51888.26,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":52915.75,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":52402.01,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":51374.51,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":51374.51,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":51374.51,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":51888.26,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":51374.51,"methodology":"case rate"}]}]},{"description":"MAGNETIC RESONANCE TECHNOLOGY GENERAL","code_information":[{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":2369,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2369,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MRS DISC PAIN TRANSMIS DATA","code_information":[{"code":"0610T","type":"CPT"}],"standard_charges":[{"minimum":355.3,"maximum":1439.38,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":355.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNETIC RESONANCE IMAGING BRAIN/BRAIN STEM","code_information":[{"code":"0611","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MRS DISC PAIN ALG ALYS DATA","code_information":[{"code":"0611T","type":"CPT"}],"standard_charges":[{"minimum":83.75,"maximum":1439.38,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":83.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNETIC RESONANCE IMAGING SPINAL CORD/SPINE","code_information":[{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MRS DISCOGENIC PAIN IR","code_information":[{"code":"0612T","type":"CPT"}],"standard_charges":[{"minimum":72.18,"maximum":1439.38,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1439.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":72.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0613","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ TCAT INTRATRL SEPTL SHT","code_information":[{"code":"0613T","type":"CPT"}],"standard_charges":[{"minimum":2536.84,"maximum":45744.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45744.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":45744.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":45744.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2536.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNETIC RESONANCE IMAGING OTHER MRI","code_information":[{"code":"0614","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"RMVLRPLCMT SS IMPL DFB PG","code_information":[{"code":"0614T","type":"CPT"}],"standard_charges":[{"minimum":1063.19,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1063.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNETIC RESONANCE ANGIOGRAPHY HEAD AND NECK","code_information":[{"code":"0615","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EYE MVMT ALYS W/O CALBRJ IR","code_information":[{"code":"0615T","type":"CPT"}],"standard_charges":[{"minimum":103.37,"maximum":190.34,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":103.37,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":190.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNETIC RESONANCE ANGIOGRAPHY LOWER EXTREMITIES","code_information":[{"code":"0616","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSERTION OF IRIS PROSTHESIS","code_information":[{"code":"0616T","type":"CPT"}],"standard_charges":[{"minimum":1604.68,"maximum":6047,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1604.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0617","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ IRIS PROSTH W/RMVLINSJ","code_information":[{"code":"0617T","type":"CPT"}],"standard_charges":[{"minimum":2389.29,"maximum":6047,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2389.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNETIC RESONANCE ANGIOGRAPHY OTHER MRA","code_information":[{"code":"0618","type":"RC"}],"standard_charges":[{"minimum":1601,"maximum":1601,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1601,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSJ IRIS PROSTH SEC IO LENS","code_information":[{"code":"0618T","type":"CPT"}],"standard_charges":[{"minimum":2552.53,"maximum":6047,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5760.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2552.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MAGNETIC RESONANCE TECHNOLOGY OTHER MRT","code_information":[{"code":"0619","type":"RC"}],"standard_charges":[{"minimum":1130,"maximum":1130,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1130,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":1130,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CYSTO W/PRST8 COMMISSUROTOMY","code_information":[{"code":"0619T","type":"CPT"}],"standard_charges":[{"minimum":1162.9,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1162.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC","code_information":[{"code":"062","type":"MS-DRG"}],"standard_charges":[{"minimum":26572.52,"maximum":47178.16,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47178.16,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":35384.73,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":35384.73,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26572.52,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":26572.52,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":27304.36,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36075,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":41314,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":26769,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44562.33,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":45007.96,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45899.2,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45453.58,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44562.33,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44562.33,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44562.33,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":45007.96,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44562.33,"methodology":"case rate"}]}]},{"description":"EVASC VEN ARTLZ TIBL/PRNL VN","code_information":[{"code":"0620T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":20758.83,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":20758.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRABECULOSTOMY INTERNO LASER","code_information":[{"code":"0621T","type":"CPT"}],"standard_charges":[{"minimum":499.44,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":499.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRABECULOSTOMY INT LSR W/SCP","code_information":[{"code":"0622T","type":"CPT"}],"standard_charges":[{"minimum":685.85,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":685.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTO QUANTIFICATION C PLAQUE","code_information":[{"code":"0623T","type":"CPT"}],"standard_charges":[{"minimum":345.18,"maximum":345.18,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":345.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTO QUAN C PLAQ DATA PREP","code_information":[{"code":"0624T","type":"CPT"}],"standard_charges":[{"minimum":124.92,"maximum":124.92,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":124.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTO QUAN C PLAQ CPTR ALYS","code_information":[{"code":"0625T","type":"CPT"}],"standard_charges":[{"minimum":65.76,"maximum":65.76,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":65.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"AUTO QUAN C PLAQ IR","code_information":[{"code":"0626T","type":"CPT"}],"standard_charges":[{"minimum":155.3,"maximum":155.3,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":155.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ NJX ALGC FLUOR LMBR 1ST","code_information":[{"code":"0627T","type":"CPT"}],"standard_charges":[{"minimum":176.6,"maximum":721.27,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":721.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ NJX ALGC FLUOR LMBR EA","code_information":[{"code":"0628T","type":"CPT"}],"standard_charges":[{"minimum":88.32,"maximum":163.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":163.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ NJX ALGC CT LMBR 1ST","code_information":[{"code":"0629T","type":"CPT"}],"standard_charges":[{"minimum":176.6,"maximum":546.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":176.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":546.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC","code_information":[{"code":"063","type":"MS-DRG"}],"standard_charges":[{"minimum":21108.1,"maximum":42998.69,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42108.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":31582.57,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":31582.57,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21108.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21108.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":21689.44,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28657,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":32818,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21264,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41746.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42163.77,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42998.69,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42581.23,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41746.3,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41746.3,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41746.3,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42163.77,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41746.3,"methodology":"case rate"}]}]},{"description":"PERQ NJX ALGC CT LMBR EA","code_information":[{"code":"0630T","type":"CPT"}],"standard_charges":[{"minimum":88.32,"maximum":163.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":163.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TC VIS LIT HYPERSPECTRAL IMG","code_information":[{"code":"0631T","type":"CPT"}],"standard_charges":[{"minimum":49.35,"maximum":174.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":49.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":49.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":174.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERQ TCAT US ABLTJ NRV P-ART","code_information":[{"code":"0632T","type":"CPT"}],"standard_charges":[{"minimum":1277.06,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1277.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT BREAST W/3D UNI C-","code_information":[{"code":"0633T","type":"CPT"}],"standard_charges":[{"minimum":263.89,"maximum":432.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":432.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT BREAST W/3D UNI C+","code_information":[{"code":"0634T","type":"CPT"}],"standard_charges":[{"minimum":263.89,"maximum":432.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":432.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT BREAST W/3D UNI C-/C+","code_information":[{"code":"0635T","type":"CPT"}],"standard_charges":[{"minimum":263.89,"maximum":432.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":263.89,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":432.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT BREAST W/3D BI C-","code_information":[{"code":"0636T","type":"CPT"}],"standard_charges":[{"minimum":337.61,"maximum":432.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":432.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT BREAST W/3D BI C+","code_information":[{"code":"0637T","type":"CPT"}],"standard_charges":[{"minimum":337.61,"maximum":432.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":432.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CT BREAST W/3D BI C-/C+","code_information":[{"code":"0638T","type":"CPT"}],"standard_charges":[{"minimum":337.61,"maximum":432.63,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":337.61,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":432.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"WRLS SKN SNR ANISOTROPY MEAS","code_information":[{"code":"0639T","type":"CPT"}],"standard_charges":[{"minimum":174.37,"maximum":181.03,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":181.03,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":174.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC","code_information":[{"code":"064","type":"MS-DRG"}],"standard_charges":[{"minimum":24052.43,"maximum":46888.65,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32068.9,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":24052.43,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":24052.43,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28436.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":28436.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":29219.76,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38606,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":44212,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":28647,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":45522.96,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":45978.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":46888.65,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":46433.42,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":45522.96,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":45522.96,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":45522.96,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":45978.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":45522.96,"methodology":"case rate"}]}]},{"description":"HOME IV THERAPY SERVICES - GENERAL","code_information":[{"code":"0640","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0640T","type":"CPT"}],"standard_charges":[{"minimum":7.17,"maximum":49.35,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":49.35,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":49.35,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - NONROUTINE NURSING, CENTRAL LINE","code_information":[{"code":"0641","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0641T","type":"CPT"}],"standard_charges":[{"minimum":48.32,"maximum":49.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":49.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - IV SITE CARE, CENTRAL LINE","code_information":[{"code":"0642","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0642T","type":"CPT"}],"standard_charges":[{"minimum":16.63,"maximum":48.32,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - IV START/CHANGE, PERIPHERAL LINE","code_information":[{"code":"0643","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0643T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - NONROUTINE NURSING, PERIPHERAL LINE","code_information":[{"code":"0644","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0644T","type":"CPT"}],"standard_charges":[{"minimum":1398.08,"maximum":3886.76,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1398.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1398.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1398.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3886.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - TRAINING PATIENT/CARE GIVER, CENTRAL LINE","code_information":[{"code":"0645","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0645T","type":"CPT"}],"standard_charges":[{"minimum":2317.85,"maximum":9252.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9252.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9252.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9252.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2317.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - TRAINING, DISABLED PATIENT, CENTRAL LINE","code_information":[{"code":"0646","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0646T","type":"CPT"}],"standard_charges":[{"minimum":3630.42,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3630.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - TRAINING, PATIENT/CARE GIVER, PERIPHERAL","code_information":[{"code":"0647","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0647T","type":"CPT"}],"standard_charges":[{"minimum":852.47,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":852.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":852.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":852.47,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1819.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - TRAINING, DISABLED PATIENT, PERIPHERAL","code_information":[{"code":"0648","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0648T","type":"CPT"}],"standard_charges":[{"minimum":653.07,"maximum":757.79,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":653.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":653.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":653.07,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":757.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOME IV THERAPY SERVICES - OTHER IV THERAPY SERVICES","code_information":[{"code":"0649","type":"RC"}],"standard_charges":[{"minimum":439.3,"maximum":439.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":439.3,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0649T","type":"CPT"}],"standard_charges":[{"minimum":293.95,"maximum":598.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":293.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":293.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":293.95,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":598.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS","code_information":[{"code":"065","type":"MS-DRG"}],"standard_charges":[{"minimum":14429.83,"maximum":39453.87,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24670.59,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18503.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18503.52,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14429.83,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14429.83,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14827.24,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19590,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22435,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14537,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38304.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38687.77,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39453.87,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39070.82,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38304.72,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38304.72,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38304.72,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38687.77,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38304.72,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0650T","type":"CPT"}],"standard_charges":[{"minimum":96.84,"maximum":130.28,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":96.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":96.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":96.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":130.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0651T","type":"CPT"}],"standard_charges":[{"minimum":528.97,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3000.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3000.61,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3000.61,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":528.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0652T","type":"CPT"}],"standard_charges":[{"minimum":664.16,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":664.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0653T","type":"CPT"}],"standard_charges":[{"minimum":805.88,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":805.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0654T","type":"CPT"}],"standard_charges":[{"minimum":308.99,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":308.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOSPICE SERVICE - INPATIENT RESPITE CARE","code_information":[{"code":"0655","type":"RC"}],"standard_charges":[{"minimum":1156.7,"maximum":1156.7,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1156.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1156.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1156.7,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0655T","type":"CPT"}],"standard_charges":[{"minimum":3021.62,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOSPICE SERVICE - GENERAL INPATIENT CARE NON-RESPITE","code_information":[{"code":"0656","type":"RC"}],"standard_charges":[{"minimum":2608.26,"maximum":2608.26,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2608.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2608.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2608.26,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0656T","type":"CPT"}],"standard_charges":[{"minimum":4611.93,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4611.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0657T","type":"CPT"}],"standard_charges":[{"minimum":4763.68,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4763.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOSPICE SERVICE - HOSPICE ROOM & BOARD-NURSING FACILITY","code_information":[{"code":"0658","type":"RC"}],"standard_charges":[{"minimum":1554.74,"maximum":1554.74,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1554.74,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1554.74,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1554.74,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0658T","type":"CPT"}],"standard_charges":[{"minimum":49.58,"maximum":56.43,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":49.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":49.58,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":56.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0659T","type":"CPT"}],"standard_charges":[{"minimum":169.36,"maximum":3069.64,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3069.64,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3069.64,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3069.64,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":169.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC","code_information":[{"code":"066","type":"MS-DRG"}],"standard_charges":[{"minimum":9760.44,"maximum":36975.36,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21359.06,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16019.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16019.8,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9760.44,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9760.44,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10029.25,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13251,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":15175,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":9833,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":35898.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36257.39,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":36975.36,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36616.37,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":35898.4,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":35898.4,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":35898.4,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36257.39,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":35898.4,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0660T","type":"CPT"}],"standard_charges":[{"minimum":163.08,"maximum":6047,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0661T","type":"CPT"}],"standard_charges":[{"minimum":163.08,"maximum":6047,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6047,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0662T","type":"CPT"}],"standard_charges":[{"minimum":18.91,"maximum":18.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18.91,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18.91,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0663T","type":"CPT"}],"standard_charges":[{"minimum":9.47,"maximum":9.47,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9.47,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9.47,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0664T","type":"CPT"}],"standard_charges":[{"minimum":3963.25,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0665T","type":"CPT"}],"standard_charges":[{"minimum":3963.25,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0666T","type":"CPT"}],"standard_charges":[{"minimum":3963.25,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0667T","type":"CPT"}],"standard_charges":[{"minimum":3963.25,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0668T","type":"CPT"}],"standard_charges":[{"minimum":3963.25,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0669T","type":"CPT"}],"standard_charges":[{"minimum":3963.25,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC","code_information":[{"code":"067","type":"MS-DRG"}],"standard_charges":[{"minimum":15361.78,"maximum":42471.94,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20481.73,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15361.78,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15361.78,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20115.73,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":20115.73,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":20669.74,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27309,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":31275,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":20265,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41234.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":41647.24,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42471.94,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42059.59,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41234.89,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41234.89,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41234.89,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":41647.24,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41234.89,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0670T","type":"CPT"}],"standard_charges":[{"minimum":3963.25,"maximum":3963.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3963.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0671T","type":"CPT"}],"standard_charges":[{"minimum":2090.9,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2090.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0672T","type":"CPT"}],"standard_charges":[{"minimum":688.1,"maximum":688.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":688.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":688.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":688.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0673T","type":"CPT"}],"standard_charges":[{"minimum":652.42,"maximum":7483.37,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":652.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":652.42,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":652.42,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7483.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0674T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0675T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0676T","type":"CPT"}],"standard_charges":[{"minimum":985.56,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0677T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0678T","type":"CPT"}],"standard_charges":[{"minimum":985.56,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0679T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC","code_information":[{"code":"068","type":"MS-DRG"}],"standard_charges":[{"minimum":11502.19,"maximum":38358.16,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15335.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11502.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11502.19,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12365.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12365.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12706.15,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16788,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":19226,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":12457,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37240.93,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37613.34,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38358.16,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37985.75,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37240.93,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37240.93,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37240.93,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37613.34,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37240.93,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0680T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMA RESPONSE - LEVEL 1","code_information":[{"code":"0681","type":"RC"}],"standard_charges":[{"minimum":9129.8,"maximum":9129.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9129.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9129.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9129.8,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMA RESPONSE LEVEL I","code_information":[{"code":"0681","type":"RC"}],"standard_charges":[{"minimum":4133,"maximum":4133,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4133,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4133,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMA RESPONSE LEVEL I","code_information":[{"code":"0681","type":"RC"}],"standard_charges":[{"minimum":4055,"maximum":4055,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4055,"methodology":"case rate"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4055,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0681T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMA RESPONSE - LEVEL 2","code_information":[{"code":"0682","type":"RC"}],"standard_charges":[{"minimum":3911.68,"maximum":3911.68,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3911.68,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3911.68,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3911.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0682T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMA RESPONSE - LEVEL 3","code_information":[{"code":"0683","type":"RC"}],"standard_charges":[{"minimum":1955.84,"maximum":1955.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1955.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1955.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1955.84,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0683T","type":"CPT"}],"standard_charges":[{"minimum":376.23,"maximum":376.23,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":376.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":376.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":376.23,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMA RESPONSE - LEVEL 4","code_information":[{"code":"0684","type":"RC"}],"standard_charges":[{"minimum":1184.2,"maximum":1184.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0684T","type":"CPT"}],"standard_charges":[{"minimum":80.75,"maximum":80.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":80.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":80.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0685T","type":"CPT"}],"standard_charges":[{"minimum":80.75,"maximum":80.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":80.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":80.75,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0686T","type":"CPT"}],"standard_charges":[{"minimum":3281.07,"maximum":3281.07,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3281.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3281.07,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3281.07,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0687T","type":"CPT"}],"standard_charges":[{"minimum":80.3,"maximum":80.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":80.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":80.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0688T","type":"CPT"}],"standard_charges":[{"minimum":80.3,"maximum":80.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":80.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":80.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMA RESPONSE - OTHER TRAUMA RESPONSE","code_information":[{"code":"0689","type":"RC"}],"standard_charges":[{"minimum":1184.2,"maximum":1184.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0689T","type":"CPT"}],"standard_charges":[{"minimum":196.5,"maximum":196.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":196.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":196.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":196.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC","code_information":[{"code":"069","type":"MS-DRG"}],"standard_charges":[{"minimum":11339.14,"maximum":37813.33,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16516.18,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12387.53,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12387.53,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11339.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11339.14,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11651.44,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15394,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17630,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":11423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36711.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.09,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37813.33,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37446.21,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36711.97,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36711.97,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36711.97,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.09,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36711.97,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0690T","type":"CPT"}],"standard_charges":[{"minimum":98.25,"maximum":98.25,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":98.25,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":98.25,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0691T","type":"CPT"}],"standard_charges":[{"minimum":18.08,"maximum":28.57,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":28.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":28.57,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":18.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0692T","type":"CPT"}],"standard_charges":[{"minimum":382,"maximum":382,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":382,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":382,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0693T","type":"CPT"}],"standard_charges":[{"minimum":189.62,"maximum":201.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":201.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":201.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":189.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0694T","type":"CPT"}],"standard_charges":[{"minimum":28.57,"maximum":88.09,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":28.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":28.57,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":88.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0695T","type":"CPT"}],"standard_charges":[{"minimum":324.17,"maximum":756.36,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":756.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":756.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":756.36,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":324.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0696T","type":"CPT"}],"standard_charges":[{"minimum":86.13,"maximum":93.4,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":93.4,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":93.4,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":93.4,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":86.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0697T","type":"CPT"}],"standard_charges":[{"minimum":922.3,"maximum":922.3,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":922.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":922.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":922.3,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0698T","type":"CPT"}],"standard_charges":[{"minimum":461.19,"maximum":598.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":461.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":461.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":461.19,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":598.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0699T","type":"CPT"}],"standard_charges":[{"minimum":243.52,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":243.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC","code_information":[{"code":"070","type":"MS-DRG"}],"standard_charges":[{"minimum":22023.33,"maximum":45279.76,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29363.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":22023.33,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":22023.33,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25405.53,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25405.53,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":26105.23,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34491,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":39500,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":25593,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43960.93,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44400.54,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45279.76,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44840.15,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43960.93,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43960.93,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43960.93,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44400.54,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43960.93,"methodology":"case rate"}]}]},{"description":"CAST ROOM","code_information":[{"code":"0700","type":"RC"}],"standard_charges":[{"minimum":378.18,"maximum":378.18,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":378.18,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":378.18,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":378.18,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0700T","type":"CPT"}],"standard_charges":[{"minimum":249.1,"maximum":249.1,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":249.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":249.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":249.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0701T","type":"CPT"}],"standard_charges":[{"minimum":124.57,"maximum":124.57,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":124.57,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":124.57,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0704T","type":"CPT"}],"standard_charges":[{"minimum":43.7,"maximum":43.7,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0705T","type":"CPT"}],"standard_charges":[{"minimum":132.13,"maximum":132.13,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0706T","type":"CPT"}],"standard_charges":[{"minimum":132.13,"maximum":132.13,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0707T","type":"CPT"}],"standard_charges":[{"minimum":267.55,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":267.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":267.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":267.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":762.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0708T","type":"CPT"}],"standard_charges":[{"minimum":32.05,"maximum":175.08,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":32.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":32.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":175.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0709T","type":"CPT"}],"standard_charges":[{"minimum":16.04,"maximum":52.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":52.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC","code_information":[{"code":"071","type":"MS-DRG"}],"standard_charges":[{"minimum":15074.37,"maximum":39795.99,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22679.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":17010.42,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":17010.42,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15074.37,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":15074.37,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":15489.54,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20465,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":23437,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":15186,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38636.88,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39023.25,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39795.99,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39409.62,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38636.88,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38636.88,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38636.88,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39023.25,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38636.88,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0710T","type":"CPT"}],"standard_charges":[{"minimum":137.44,"maximum":137.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0711T","type":"CPT"}],"standard_charges":[{"minimum":137.44,"maximum":137.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0712T","type":"CPT"}],"standard_charges":[{"minimum":137.44,"maximum":137.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0713T","type":"CPT"}],"standard_charges":[{"minimum":137.44,"maximum":137.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":137.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0714T","type":"CPT"}],"standard_charges":[{"minimum":3021.62,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0715T","type":"CPT"}],"standard_charges":[{"minimum":1717.36,"maximum":1717.36,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1717.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1717.36,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1717.36,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0716T","type":"CPT"}],"standard_charges":[{"minimum":308.24,"maximum":308.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":308.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":308.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0717T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0718T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0719T","type":"CPT"}],"standard_charges":[{"minimum":3965.16,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC","code_information":[{"code":"072","type":"MS-DRG"}],"standard_charges":[{"minimum":11116.25,"maximum":37695.02,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17361.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13021.62,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13021.62,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11116.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11116.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11422.4,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15092,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17283,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":11198,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36597.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36963.08,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37695.02,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37329.05,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36597.1,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36597.1,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36597.1,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36963.08,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36597.1,"methodology":"case rate"}]}]},{"description":"LABOR ROOM/DELIVERY - GENERAL","code_information":[{"code":"0720","type":"RC"}],"standard_charges":[{"minimum":1719,"maximum":1719,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR/DELIVERY","code_information":[{"code":"0720","type":"RC"}],"standard_charges":[{"minimum":1417,"maximum":1927,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1681,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1417,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1927,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0720T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR ROOM/DELIVERY - LABOR","code_information":[{"code":"0721","type":"RC"}],"standard_charges":[{"minimum":1719,"maximum":1719,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR/DELIVERY","code_information":[{"code":"0721","type":"RC"}],"standard_charges":[{"minimum":1417,"maximum":1927,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1681,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1417,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1927,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0721T","type":"CPT"}],"standard_charges":[{"minimum":119.6,"maximum":119.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR ROOM/DELIVERY - DELIVERY","code_information":[{"code":"0722","type":"RC"}],"standard_charges":[{"minimum":1719,"maximum":1719,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR/DELIVERY","code_information":[{"code":"0722","type":"RC"}],"standard_charges":[{"minimum":1417,"maximum":1927,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1681,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1417,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1927,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0722T","type":"CPT"}],"standard_charges":[{"minimum":119.6,"maximum":119.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":119.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR ROOM/DELIVERY - CIRCUMSICION","code_information":[{"code":"0723","type":"RC"}],"standard_charges":[{"minimum":1719,"maximum":1719,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1719,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0723T","type":"CPT"}],"standard_charges":[{"minimum":2326.38,"maximum":2326.38,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2326.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2326.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2326.38,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR ROOM/DELIVERY - BIRTHING CENTER","code_information":[{"code":"0724","type":"RC"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR/DELIVERY","code_information":[{"code":"0724","type":"RC"}],"standard_charges":[{"minimum":1417,"maximum":1927,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1681,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1417,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1927,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0724T","type":"CPT"}],"standard_charges":[{"minimum":366.76,"maximum":366.76,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":366.76,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":366.76,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":366.76,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0725T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0726T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0727T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0728T","type":"CPT"}],"standard_charges":[{"minimum":610.05,"maximum":610.05,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":610.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":610.05,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":610.05,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR ROOM/DELIVERY - OTHER LABOR ROOM/DELIVERY","code_information":[{"code":"0729","type":"RC"}],"standard_charges":[{"minimum":1910,"maximum":1910,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1910,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1910,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1910,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LABOR/DELIVERY","code_information":[{"code":"0729","type":"RC"}],"standard_charges":[{"minimum":1417,"maximum":1927,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1681,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1417,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1927,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0729T","type":"CPT"}],"standard_charges":[{"minimum":349.8,"maximum":349.8,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":349.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":349.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":349.8,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC","code_information":[{"code":"073","type":"MS-DRG"}],"standard_charges":[{"minimum":16606.03,"maximum":43196.12,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22140.68,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16606.03,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16606.03,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21480.06,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21480.06,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22071.64,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29162,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":33396,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21639,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41937.98,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42357.36,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43196.12,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42776.74,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41937.98,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41937.98,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41937.98,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42357.36,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41937.98,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0730T","type":"CPT"}],"standard_charges":[{"minimum":3732.14,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOLTER MONITOR","code_information":[{"code":"0731","type":"RC"}],"standard_charges":[{"minimum":1236,"maximum":1678,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1467,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1236,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1678,"methodology":"case rate"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0731","type":"APR-DRG"}],"standard_charges":[{"minimum":5957,"maximum":5957,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5957,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5957,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5957,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0731T","type":"CPT"}],"standard_charges":[{"minimum":3021.62,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HOLTER MONITOR","code_information":[{"code":"0732","type":"RC"}],"standard_charges":[{"minimum":1236,"maximum":1678,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1467,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1236,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1678,"methodology":"case rate"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0732","type":"APR-DRG"}],"standard_charges":[{"minimum":8463,"maximum":8463,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8463,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8463,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8463,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0732T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0733","type":"APR-DRG"}],"standard_charges":[{"minimum":14400,"maximum":14400,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14400,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14400,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14400,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0733T","type":"CPT"}],"standard_charges":[{"minimum":423.52,"maximum":423.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":423.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":423.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":423.52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0734","type":"APR-DRG"}],"standard_charges":[{"minimum":27338,"maximum":27338,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":27338,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":27338,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":27338,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0734T","type":"CPT"}],"standard_charges":[{"minimum":423.52,"maximum":423.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":423.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":423.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":423.52,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0735T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0736T","type":"CPT"}],"standard_charges":[{"minimum":3965.16,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0737T","type":"CPT"}],"standard_charges":[{"minimum":3732.14,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0738T","type":"CPT"}],"standard_charges":[{"minimum":249.68,"maximum":249.68,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":249.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":249.68,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":249.68,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0739T","type":"CPT"}],"standard_charges":[{"minimum":3021.62,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC","code_information":[{"code":"074","type":"MS-DRG"}],"standard_charges":[{"minimum":12691.41,"maximum":39527.72,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16921.35,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12691.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12691.41,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14568.96,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14568.96,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14970.21,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19779,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22651,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14677,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38376.42,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38760.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39527.72,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39143.95,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38376.42,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38376.42,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38376.42,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38760.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38376.42,"methodology":"case rate"}]}]},{"description":"EEG","code_information":[{"code":"0740","type":"RC"}],"standard_charges":[{"minimum":892,"maximum":3457,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3457,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":892,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1207,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0740T","type":"CPT"}],"standard_charges":[{"minimum":261.59,"maximum":261.59,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":261.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":261.59,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":261.59,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0741T","type":"CPT"}],"standard_charges":[{"minimum":807.62,"maximum":807.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":807.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":807.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":807.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0742T","type":"CPT"}],"standard_charges":[{"minimum":43.62,"maximum":43.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":43.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":43.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0743T","type":"CPT"}],"standard_charges":[{"minimum":509.24,"maximum":509.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0744T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0745T","type":"CPT"}],"standard_charges":[{"minimum":12303.84,"maximum":12303.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0746T","type":"CPT"}],"standard_charges":[{"minimum":12303.84,"maximum":12303.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0747T","type":"CPT"}],"standard_charges":[{"minimum":12303.84,"maximum":12303.84,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12303.84,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0748T","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0749T","type":"CPT"}],"standard_charges":[{"minimum":509.24,"maximum":509.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIRAL MENINGITIS WITH CC/MCC","code_information":[{"code":"075","type":"MS-DRG"}],"standard_charges":[{"minimum":16333.25,"maximum":46216.46,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21776.99,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16333.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16333.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27170.22,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":27170.22,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":27918.51,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36887,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":42243,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":27371,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44870.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":45319.05,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":46216.46,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45767.75,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44870.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44870.34,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44870.34,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":45319.05,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44870.34,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0750T","type":"CPT"}],"standard_charges":[{"minimum":509.24,"maximum":509.24,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":509.24,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0751T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0752T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0753T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0754T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0755T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0756T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0757T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0758T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0759T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"VIRAL MENINGITIS WITHOUT CC/MCC","code_information":[{"code":"076","type":"MS-DRG"}],"standard_charges":[{"minimum":12157.82,"maximum":38746.26,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16209.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12157.82,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12157.82,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13096.73,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":13096.73,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13457.43,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17780,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":20362,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13194,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37617.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37993.9,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38746.26,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38370.08,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37617.72,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37617.72,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37617.72,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37993.9,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37617.72,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0760T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0761T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OBSERVATION","code_information":[{"code":"0762","type":"RC"}],"standard_charges":[{"minimum":3016,"maximum":4123,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_percentage":47.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4102,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3016,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4123,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0762T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0763T","type":"CPT"}],"standard_charges":[{"minimum":0.04,"maximum":0.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":0.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0764T","type":"CPT"}],"standard_charges":[{"minimum":54.93,"maximum":54.93,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":54.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":54.93,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0765T","type":"CPT"}],"standard_charges":[{"minimum":109.83,"maximum":109.83,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":109.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":109.83,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0766T","type":"CPT"}],"standard_charges":[{"minimum":555.62,"maximum":555.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0767T","type":"CPT"}],"standard_charges":[{"minimum":277.83,"maximum":277.83,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":277.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":277.83,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0768T","type":"CPT"}],"standard_charges":[{"minimum":555.62,"maximum":555.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":555.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0769T","type":"CPT"}],"standard_charges":[{"minimum":277.83,"maximum":277.83,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":277.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":277.83,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HYPERTENSIVE ENCEPHALOPATHY WITH MCC","code_information":[{"code":"077","type":"MS-DRG"}],"standard_charges":[{"minimum":19934.42,"maximum":43180.3,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26578.39,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19934.42,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19934.42,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21450.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21450.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22041.01,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29121,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":33350,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21609,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41922.62,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42341.85,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43180.3,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42761.08,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41922.62,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41922.62,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41922.62,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42341.85,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41922.62,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0770T","type":"CPT"}],"standard_charges":[{"minimum":10.58,"maximum":10.58,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0771T","type":"CPT"}],"standard_charges":[{"minimum":21.16,"maximum":21.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0772T","type":"CPT"}],"standard_charges":[{"minimum":10.58,"maximum":10.58,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0773T","type":"CPT"}],"standard_charges":[{"minimum":21.16,"maximum":21.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0774T","type":"CPT"}],"standard_charges":[{"minimum":10.58,"maximum":10.58,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10.58,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0775T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0776T","type":"CPT"}],"standard_charges":[{"minimum":1303.19,"maximum":1303.19,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1303.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1303.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1303.19,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0777T","type":"CPT"}],"standard_charges":[{"minimum":453.74,"maximum":453.74,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":453.74,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":453.74,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":453.74,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0778T","type":"CPT"}],"standard_charges":[{"minimum":98.86,"maximum":98.86,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":98.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":98.86,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0779T","type":"CPT"}],"standard_charges":[{"minimum":469.29,"maximum":469.29,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":469.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":469.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":469.29,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HYPERTENSIVE ENCEPHALOPATHY WITH CC","code_information":[{"code":"078","type":"MS-DRG"}],"standard_charges":[{"minimum":14436.93,"maximum":39457.64,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20003.18,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15002.86,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15002.86,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14436.93,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14436.93,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14834.54,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19600,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22446,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14544,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38308.38,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38691.47,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39457.64,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39074.55,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38308.38,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38308.38,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38308.38,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38691.47,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38308.38,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0780T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0781T","type":"CPT"}],"standard_charges":[{"minimum":985.56,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0782T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0783T","type":"CPT"}],"standard_charges":[{"minimum":134.62,"maximum":134.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":134.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":134.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC","code_information":[{"code":"079","type":"MS-DRG"}],"standard_charges":[{"minimum":10517.14,"maximum":37377.01,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17897.58,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13423.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13423.61,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10517.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10517.14,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10806.79,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14278,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":16352,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":10595,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36288.35,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36651.24,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37377.01,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37014.12,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36288.35,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36288.35,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36288.35,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36651.24,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36288.35,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0791T","type":"CPT"}],"standard_charges":[{"minimum":41.94,"maximum":41.94,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":41.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":41.94,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0792T","type":"CPT"}],"standard_charges":[{"minimum":114.6,"maximum":114.6,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":114.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":114.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0793T","type":"CPT"}],"standard_charges":[{"minimum":9252.04,"maximum":9252.04,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9252.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9252.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9252.04,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0794T","type":"CPT"}],"standard_charges":[{"minimum":8825.16,"maximum":8825.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8825.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8825.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8825.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0795T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0796T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0797T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0798T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0799T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONTRAUMATIC STUPOR AND COMA WITH MCC","code_information":[{"code":"080","type":"MS-DRG"}],"standard_charges":[{"minimum":14888,"maximum":48753,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19850.05,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14888,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14888,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31356.91,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":31356.91,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":32220.52,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42570,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":48753,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":31589,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":47027.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":47498.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48438.75,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":47968.47,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":47027.91,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":47027.91,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":47027.91,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":47498.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":47027.91,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0800T","type":"CPT"}],"standard_charges":[{"minimum":2639.62,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0801T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0802T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0803T","type":"CPT"}],"standard_charges":[{"minimum":5890.44,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0804T","type":"CPT"}],"standard_charges":[{"minimum":102.49,"maximum":102.49,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":102.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":102.49,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0805T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0806T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0807T","type":"CPT"}],"standard_charges":[{"minimum":716.29,"maximum":716.29,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":716.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":716.29,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0808T","type":"CPT"}],"standard_charges":[{"minimum":716.29,"maximum":716.29,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":716.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":716.29,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0809T","type":"CPT"}],"standard_charges":[{"minimum":7926.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NONTRAUMATIC STUPOR AND COMA WITHOUT MCC","code_information":[{"code":"081","type":"MS-DRG"}],"standard_charges":[{"minimum":11827.61,"maximum":38648.29,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15769.65,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11827.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11827.61,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12912.17,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12912.17,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13267.79,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17530,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":20075,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13008,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37522.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37897.84,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38648.29,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38273.07,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37522.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37522.61,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37522.61,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37897.84,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37522.61,"methodology":"case rate"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"0810T","type":"CPT"}],"standard_charges":[{"minimum":379.78,"maximum":379.78,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":379.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":379.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":379.78,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC","code_information":[{"code":"082","type":"MS-DRG"}],"standard_charges":[{"minimum":29809.5,"maximum":50289,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39744.76,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":29809.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":29809.5,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32345.03,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32345.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":33235.84,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43912,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":50289,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":32584,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":47537.13,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":48012.51,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48963.25,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":48487.88,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":47537.13,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":47537.13,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":47537.13,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":48012.51,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":47537.13,"methodology":"case rate"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0821","type":"APR-DRG"}],"standard_charges":[{"minimum":3645,"maximum":3645,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3645,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3645,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3645,"methodology":"case rate"}]}]},{"description":"HEMO/COMPOSITE","code_information":[{"code":"0821","type":"RC"}],"standard_charges":[{"minimum":764,"maximum":764,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":764,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":764,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":764,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0822","type":"APR-DRG"}],"standard_charges":[{"minimum":4446,"maximum":4446,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4446,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4446,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4446,"methodology":"case rate"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0823","type":"APR-DRG"}],"standard_charges":[{"minimum":6817,"maximum":6817,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6817,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6817,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6817,"methodology":"case rate"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0824","type":"APR-DRG"}],"standard_charges":[{"minimum":15858,"maximum":15858,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15858,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15858,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15858,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC","code_information":[{"code":"083","type":"MS-DRG"}],"standard_charges":[{"minimum":19256.81,"maximum":42016.02,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31676.49,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":23758.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":23758.11,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19256.81,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":19256.81,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19787.16,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26143,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":29940,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":19399,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40792.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":41200.18,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42016.02,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41608.1,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40792.25,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40792.25,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40792.25,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":41200.18,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40792.25,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0830","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0831","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERTNL/COMPOSITE","code_information":[{"code":"0831","type":"RC"}],"standard_charges":[{"minimum":668.5,"maximum":668.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":668.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":668.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":668.5,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0832","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0833","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0834","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0835","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0839","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC","code_information":[{"code":"084","type":"MS-DRG"}],"standard_charges":[{"minimum":13056.98,"maximum":38725.16,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26393.35,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19795.63,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19795.63,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13056.98,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":13056.98,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13416.58,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17726,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":20301,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13154,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37597.24,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37973.22,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38725.16,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38349.19,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37597.24,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37597.24,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37597.24,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37973.22,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37597.24,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0840","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"CAPD/COMPOSITE","code_information":[{"code":"0841","type":"RC"}],"standard_charges":[{"minimum":611.2,"maximum":611.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":611.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":611.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":611.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0841","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0842","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0843","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0844","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"CAPD/HOME/SUPSERV","code_information":[{"code":"0845","type":"RC"}],"standard_charges":[{"minimum":764,"maximum":764,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":764,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":764,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":764,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0845","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0849","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC","code_information":[{"code":"085","type":"MS-DRG"}],"standard_charges":[{"minimum":25837.45,"maximum":50168,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34448.86,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":25837.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":25837.45,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32266.94,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32266.94,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":33155.61,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43806,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":50168,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":32506,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":47496.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":47971.86,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48921.8,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":48446.83,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":47496.89,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":47496.89,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":47496.89,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":47971.86,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":47496.89,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0850","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"CAPD/COMPOSITE","code_information":[{"code":"0851","type":"RC"}],"standard_charges":[{"minimum":668.5,"maximum":668.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":668.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":668.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":668.5,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0851","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0852","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0853","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0854","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0855","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"PERITONEAL DIALYSIS, CAPD AND CCPD","code_information":[{"code":"0859","type":"RC"}],"standard_charges":[{"minimum":689,"maximum":833,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":689,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":833,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC","code_information":[{"code":"086","type":"MS-DRG"}],"standard_charges":[{"minimum":18698.87,"maximum":41719.87,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25078.95,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18809.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18809.8,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18698.87,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18698.87,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19213.85,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25386,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":29072,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":18837,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40504.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40909.77,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41719.87,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41314.82,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40504.72,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40504.72,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40504.72,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40909.77,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40504.72,"methodology":"case rate"}]}]},{"description":"MEG","code_information":[{"code":"0860","type":"RC"}],"standard_charges":[{"minimum":4872,"maximum":5533,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5533,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4872,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":5507,"methodology":"case rate"}]}]},{"description":"MEG","code_information":[{"code":"0861","type":"RC"}],"standard_charges":[{"minimum":4872,"maximum":5533,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5533,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4872,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":5507,"methodology":"case rate"}]}]},{"description":"TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC","code_information":[{"code":"087","type":"MS-DRG"}],"standard_charges":[{"minimum":12581.38,"maximum":38472.71,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18771.73,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14079.24,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14079.24,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12581.38,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12581.38,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12927.89,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17081,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":19561,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":12674,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37352.14,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37725.67,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38472.71,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38099.19,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37352.14,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37352.14,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37352.14,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37725.67,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37352.14,"methodology":"case rate"}]}]},{"description":"CONCUSSION WITH MCC","code_information":[{"code":"088","type":"MS-DRG"}],"standard_charges":[{"minimum":16500.75,"maximum":43352.87,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22000.31,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16500.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16500.75,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21775.36,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21775.36,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22375.07,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29562,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":33856,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21936,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42090.16,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42511.07,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43352.87,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42931.97,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42090.16,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42090.16,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42090.16,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42511.07,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42090.16,"methodology":"case rate"}]}]},{"description":"CONCUSSION WITH CC","code_information":[{"code":"089","type":"MS-DRG"}],"standard_charges":[{"minimum":12059.71,"maximum":40459.89,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16079.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12059.71,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12059.71,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16325.13,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":16325.13,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16774.74,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22163,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":25382,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":16446,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39281.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39674.26,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40459.89,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40067.07,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39281.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39281.44,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39281.44,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39674.26,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39281.44,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0891","type":"APR-DRG"}],"standard_charges":[{"minimum":10452,"maximum":10452,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10452,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10452,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10452,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0892","type":"APR-DRG"}],"standard_charges":[{"minimum":13665,"maximum":13665,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13665,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13665,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13665,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0893","type":"APR-DRG"}],"standard_charges":[{"minimum":24002,"maximum":24002,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24002,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24002,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24002,"methodology":"case rate"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0894","type":"APR-DRG"}],"standard_charges":[{"minimum":40446,"maximum":40446,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40446,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40446,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40446,"methodology":"case rate"}]}]},{"description":"CONCUSSION WITHOUT CC/MCC","code_information":[{"code":"090","type":"MS-DRG"}],"standard_charges":[{"minimum":9891.84,"maximum":38838.95,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13188.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9891.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9891.84,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13271.36,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":13271.36,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13636.86,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18017,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":20634,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13370,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37707.71,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38084.79,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38838.95,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38461.87,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37707.71,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37707.71,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37707.71,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38084.79,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37707.71,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC","code_information":[{"code":"091","type":"MS-DRG"}],"standard_charges":[{"minimum":18486.77,"maximum":45277.51,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24648.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":18486.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":18486.77,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25401.27,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25401.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":26100.85,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34485,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":39493,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":25589,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43958.74,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44398.33,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45277.51,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44837.92,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43958.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43958.74,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43958.74,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44398.33,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43958.74,"methodology":"case rate"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0911","type":"APR-DRG"}],"standard_charges":[{"minimum":9201,"maximum":9201,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9201,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9201,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9201,"methodology":"case rate"}]}]},{"description":"BEHAVIORAL HLTH TRXMNT/SERVICES - PARTIAL HOSPITALIZATION-LESS INTENSIVE","code_information":[{"code":"0912","type":"RC"}],"standard_charges":[{"minimum":1184.2,"maximum":1184.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0912","type":"APR-DRG"}],"standard_charges":[{"minimum":13801,"maximum":13801,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13801,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13801,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13801,"methodology":"case rate"}]}]},{"description":"BEHAVIORAL HLTH TRXMNT/SERVICES - PARTIAL HOSPITALIZATION-INTENSIVE","code_information":[{"code":"0913","type":"RC"}],"standard_charges":[{"minimum":1184.2,"maximum":1184.2,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1184.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0913","type":"APR-DRG"}],"standard_charges":[{"minimum":24203,"maximum":24203,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24203,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24203,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24203,"methodology":"case rate"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0914","type":"APR-DRG"}],"standard_charges":[{"minimum":40663,"maximum":40663,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40663,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40663,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40663,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM WITH CC","code_information":[{"code":"092","type":"MS-DRG"}],"standard_charges":[{"minimum":13301.58,"maximum":39526.97,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17734.88,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13301.58,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13301.58,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14567.54,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14567.54,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14968.75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19777,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22649,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14675,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38375.69,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38759.45,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39526.97,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39143.21,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38375.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38375.69,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38375.69,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38759.45,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38375.69,"methodology":"case rate"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0921","type":"APR-DRG"}],"standard_charges":[{"minimum":8540,"maximum":8540,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8540,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8540,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8540,"methodology":"case rate"}]}]},{"description":"EMG","code_information":[{"code":"0922","type":"RC"}],"standard_charges":[{"minimum":914,"maximum":1102,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1085,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":914,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1102,"methodology":"case rate"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0922","type":"APR-DRG"}],"standard_charges":[{"minimum":10881,"maximum":10881,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10881,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10881,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10881,"methodology":"case rate"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0923","type":"APR-DRG"}],"standard_charges":[{"minimum":17089,"maximum":17089,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17089,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17089,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17089,"methodology":"case rate"}]}]},{"description":"ALLERGY TESTING","code_information":[{"code":"0924","type":"RC"}],"standard_charges":[{"minimum":202,"maximum":246,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":242,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":202,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":246,"methodology":"case rate"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0924","type":"APR-DRG"}],"standard_charges":[{"minimum":30677,"maximum":30677,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":30677,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":30677,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":30677,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC","code_information":[{"code":"093","type":"MS-DRG"}],"standard_charges":[{"minimum":10762.81,"maximum":37630.21,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14349.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10762.81,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10762.81,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10994.16,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10994.16,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11296.95,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14926,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17093,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":11075,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36534.18,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36899.53,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37630.21,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37264.87,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36534.18,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36534.18,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36534.18,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36899.53,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36534.18,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC","code_information":[{"code":"094","type":"MS-DRG"}],"standard_charges":[{"minimum":40995.84,"maximum":79964,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54659.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":40995.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":40995.84,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51431.47,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":51431.47,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":52847.95,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69824,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":79964,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":51812,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":57373.13,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":57946.87,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":59094.33,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":58520.6,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":57373.13,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":57373.13,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":57373.13,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":57946.87,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":57373.13,"methodology":"case rate"}]}]},{"description":"OTHER THERAPEUTIC SERVICES","code_information":[{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":257,"maximum":864,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":864,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":304,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":257,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":315,"methodology":"case rate"}]}]},{"description":"OTHER THERAPEUTIC SERVICES","code_information":[{"code":"0941","type":"RC"}],"standard_charges":[{"minimum":257,"maximum":315,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":304,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":257,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":315,"methodology":"case rate"}]}]},{"description":"CARDIAC REHAB","code_information":[{"code":"0943","type":"RC"}],"standard_charges":[{"minimum":194,"maximum":370,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":370,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":230,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":194,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":233,"methodology":"case rate"}]}]},{"description":"PULMONARY REHAB","code_information":[{"code":"0948","type":"RC"}],"standard_charges":[{"minimum":200,"maximum":233,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":230,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":200,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":233,"methodology":"case rate"}]}]},{"description":"OTHER THERAPEUTIC SERVICES","code_information":[{"code":"0949","type":"RC"}],"standard_charges":[{"minimum":864,"maximum":864,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":864,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC","code_information":[{"code":"095","type":"MS-DRG"}],"standard_charges":[{"minimum":33420.24,"maximum":52626,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44558.92,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":33420.24,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":33420.24,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33848.49,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":33848.49,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":34780.71,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45953,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":52626,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":34099,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":48311.92,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":48795.04,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":49761.28,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":49278.16,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":48311.92,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":48311.92,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":48311.92,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":48795.04,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":48311.92,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0951","type":"APR-DRG"}],"standard_charges":[{"minimum":4848,"maximum":4848,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4848,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4848,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4848,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0952","type":"APR-DRG"}],"standard_charges":[{"minimum":5284,"maximum":5284,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5284,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5284,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5284,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0953","type":"APR-DRG"}],"standard_charges":[{"minimum":8203,"maximum":8203,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8203,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8203,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8203,"methodology":"case rate"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0954","type":"APR-DRG"}],"standard_charges":[{"minimum":18375,"maximum":18375,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":18375,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":18375,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":18375,"methodology":"case rate"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC","code_information":[{"code":"096","type":"MS-DRG"}],"standard_charges":[{"minimum":30560.84,"maximum":48220.22,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40746.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":30560.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":30560.84,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30945.2,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":30945.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":31797.46,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42012,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":48113,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":31174,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":46815.74,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":47283.9,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48220.22,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":47752.06,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":46815.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":46815.74,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":46815.74,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":47283.9,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":46815.74,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC","code_information":[{"code":"097","type":"MS-DRG"}],"standard_charges":[{"minimum":31891.24,"maximum":80277,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42520.32,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":31891.24,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":31891.24,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51633.07,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":51633.07,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":53055.1,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70098,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":80277,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":52015,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":57477.02,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":58051.8,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":59201.34,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":58626.57,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":57477.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":57477.02,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":57477.02,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":58051.8,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":57477.02,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0971","type":"APR-DRG"}],"standard_charges":[{"minimum":3601,"maximum":3601,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3601,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3601,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3601,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0972","type":"APR-DRG"}],"standard_charges":[{"minimum":5250,"maximum":5250,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5250,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5250,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5250,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0973","type":"APR-DRG"}],"standard_charges":[{"minimum":9184,"maximum":9184,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9184,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9184,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9184,"methodology":"case rate"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0974","type":"APR-DRG"}],"standard_charges":[{"minimum":16337,"maximum":16337,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16337,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16337,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16337,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC","code_information":[{"code":"098","type":"MS-DRG"}],"standard_charges":[{"minimum":24600.38,"maximum":48030.32,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32799.47,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":24600.38,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":24600.38,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30587.44,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":30587.44,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":31429.85,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41526,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":47556,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":30814,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":46631.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":47097.69,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48030.32,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":47564,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":46631.37,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":46631.37,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":46631.37,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":47097.69,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":46631.37,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0981","type":"APR-DRG"}],"standard_charges":[{"minimum":5899,"maximum":5899,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5899,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5899,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5899,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0982","type":"APR-DRG"}],"standard_charges":[{"minimum":8339,"maximum":8339,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8339,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8339,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8339,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0983","type":"APR-DRG"}],"standard_charges":[{"minimum":14321,"maximum":14321,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14321,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14321,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14321,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0984","type":"APR-DRG"}],"standard_charges":[{"minimum":26356,"maximum":26356,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26356,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26356,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26356,"methodology":"case rate"}]}]},{"description":"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC","code_information":[{"code":"099","type":"MS-DRG"}],"standard_charges":[{"minimum":18742.88,"maximum":41743.23,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28983.88,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":21738.59,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":21738.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18742.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18742.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19259.08,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25446,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":29141,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":18882,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40527.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40932.68,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41743.23,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41337.95,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40527.4,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40527.4,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40527.4,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40932.68,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40527.4,"methodology":"case rate"}]}]},{"description":"SEIZURES WITH MCC","code_information":[{"code":"100","type":"MS-DRG"}],"standard_charges":[{"minimum":16615.6,"maximum":46734.16,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22153.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16615.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16615.6,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28145.55,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":28145.55,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":28920.71,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38211,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":43760,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":28354,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":45372.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":45826.7,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":46734.16,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":46280.43,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":45372.97,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":45372.97,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":45372.97,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":45826.7,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":45372.97,"methodology":"case rate"}]}]},{"description":"FNA BX W/O IMG GDN EA ADDL","code_information":[{"code":"10004","type":"CPT"}],"standard_charges":[{"minimum":44.35,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":361.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":361.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":361.45,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":91.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"}]}]},{"description":"FNA BX US GDE 1ST LESION","code_information":[{"code":"10005","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1492.48,"maximum":2300.672,"gross_charge":2816,"discounted_cash":1126.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1492.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2300.68,"methodology":"fee schedule"}]}]},{"description":"FNA BX US GDE 1ST LESION","code_information":[{"code":"10005","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":77.16,"maximum":2300.672,"gross_charge":2816,"discounted_cash":1126.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1492.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2300.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/US GDN EA ADDL","code_information":[{"code":"10006","type":"CPT"}],"standard_charges":[{"minimum":52.28,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":108.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.28,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/FLUOR GDN 1ST LES","code_information":[{"code":"10007","type":"CPT"}],"standard_charges":[{"minimum":92.66,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":191.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":92.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":92.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":92.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/FLUOR GDN EA ADDL","code_information":[{"code":"10008","type":"CPT"}],"standard_charges":[{"minimum":54.8,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":113.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.8,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/CT GDN 1ST LES","code_information":[{"code":"10009","type":"CPT"}],"standard_charges":[{"minimum":113.93,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":235.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/CT GDN EA ADDL","code_information":[{"code":"10010","type":"CPT"}],"standard_charges":[{"minimum":74.99,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1128.66,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":155.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.99,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/MR GDN 1ST LES","code_information":[{"code":"10011","type":"CPT"}],"standard_charges":[{"minimum":102.93,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1243.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1243.83,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1243.83,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":217.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/MR GDN EA ADDL","code_information":[{"code":"10012","type":"CPT"}],"standard_charges":[{"minimum":67.1,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":621.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":621.9,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":621.9,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":141.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.1,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.1,"methodology":"fee schedule"}]}]},{"description":"FNA BX W/O IMG GDN 1ST LES","code_information":[{"code":"10021","type":"CPT"}],"standard_charges":[{"minimum":57.33,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":361.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":361.45,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":361.45,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":118.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"IMAGE CATH FLUID SOFT TISSUE","code_information":[{"code":"10030","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":2033.61,"maximum":3134.829,"gross_charge":3837,"discounted_cash":1534.8,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":2033.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":3134.83,"methodology":"fee schedule"}]}]},{"description":"IMAGE CATH FLUID SOFT TISSUE","code_information":[{"code":"10030","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":140.61,"maximum":3134.829,"gross_charge":3837,"discounted_cash":1534.8,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":2033.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":3134.83,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":140.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":140.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":140.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV SOFT TISS 1ST IMAG","code_information":[{"code":"10035","type":"CPT"}],"standard_charges":[{"minimum":88.33,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":182.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV SOFT TISS ADD IMAG","code_information":[{"code":"10036","type":"CPT"}],"standard_charges":[{"minimum":44.35,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"}]}]},{"description":"ACNE SURGERY","code_information":[{"code":"10040","type":"CPT"}],"standard_charges":[{"minimum":112.27,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":112.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF SKIN ABSCESS","code_information":[{"code":"10060","type":"CPT"}],"standard_charges":[{"minimum":110.32,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":227.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":110.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":110.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":110.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF SKIN ABSCESS","code_information":[{"code":"10061","type":"CPT"}],"standard_charges":[{"minimum":192.17,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":397.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF PILONIDAL CYST","code_information":[{"code":"10080","type":"CPT"}],"standard_charges":[{"minimum":109.24,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":225.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF PILONIDAL CYST","code_information":[{"code":"10081","type":"CPT"}],"standard_charges":[{"minimum":178.83,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":369.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"SEIZURES WITHOUT MCC","code_information":[{"code":"101","type":"MS-DRG"}],"standard_charges":[{"minimum":10975.77,"maximum":38649.05,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14633.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10975.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10975.77,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12913.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12913.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13269.24,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17532,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":20078,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13009,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37523.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37898.58,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38649.05,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38273.81,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37523.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37523.34,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37523.34,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37898.58,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37523.34,"methodology":"case rate"}]}]},{"description":"REMOVE FOREIGN BODY","code_information":[{"code":"10120","type":"CPT"}],"standard_charges":[{"minimum":109.96,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":227.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.96,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"REMOVE FOREIGN BODY","code_information":[{"code":"10121","type":"CPT"}],"standard_charges":[{"minimum":192.17,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":397.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF HEMATOMA/FLUID","code_information":[{"code":"10140","type":"CPT"}],"standard_charges":[{"minimum":123.3,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":254.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"PUNCTURE DRAINAGE OF LESION","code_information":[{"code":"10160","type":"CPT"}],"standard_charges":[{"minimum":100.95,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":208.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"COMPLEX DRAINAGE WOUND","code_information":[{"code":"10180","type":"CPT"}],"standard_charges":[{"minimum":186.4,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":385.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"HEADACHES WITH MCC","code_information":[{"code":"102","type":"MS-DRG"}],"standard_charges":[{"minimum":11834.79,"maximum":40887.16,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15779.22,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11834.79,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11834.79,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17130.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":17130.1,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17601.88,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23256,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":26633,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":17257,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39696.27,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40093.24,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40887.16,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40490.2,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39696.27,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39696.27,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39696.27,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40093.24,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39696.27,"methodology":"case rate"}]}]},{"description":"HEADACHES WITHOUT MCC","code_information":[{"code":"103","type":"MS-DRG"}],"standard_charges":[{"minimum":9073.5,"maximum":38142.65,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12097.62,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9073.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9073.5,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11959.55,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11959.55,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12288.93,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16236,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":18594,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":12048,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37031.69,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37402.01,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38142.65,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37772.33,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37031.69,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37031.69,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37031.69,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37402.01,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37031.69,"methodology":"case rate"}]}]},{"description":"DEBRIDE INFECTED SKIN","code_information":[{"code":"11000","type":"CPT"}],"standard_charges":[{"minimum":28.48,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":58.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE INFECTED SKIN ADD-ON","code_information":[{"code":"11001","type":"CPT"}],"standard_charges":[{"minimum":15.5,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":32.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.5,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.5,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE GENITALIA  PERINEUM","code_information":[{"code":"11004","type":"CPT"}],"standard_charges":[{"minimum":589.84,"maximum":3916,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1219.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3047,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3916,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":589.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":589.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":589.84,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE ABDOM WALL","code_information":[{"code":"11005","type":"CPT"}],"standard_charges":[{"minimum":800.75,"maximum":3916,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1655.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3047,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3916,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":800.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":800.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":800.75,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE GENIT/PER/ABDOM WALL","code_information":[{"code":"11006","type":"CPT"}],"standard_charges":[{"minimum":725.76,"maximum":3916,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1500.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3047,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3916,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":725.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":725.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":725.76,"methodology":"fee schedule"}]}]},{"description":"REMOVE MESH FROM ABD WALL","code_information":[{"code":"11008","type":"CPT"}],"standard_charges":[{"minimum":282.66,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":584.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":282.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":282.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":282.66,"methodology":"fee schedule"}]}]},{"description":"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1101","type":"APR-DRG"}],"standard_charges":[{"minimum":4668,"maximum":4668,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4668,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4668,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4668,"methodology":"case rate"}]}]},{"description":"DEBRIDE SKIN AT FX SITE","code_information":[{"code":"11010","type":"CPT"}],"standard_charges":[{"minimum":288.43,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":596.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"ROOM PVT GENERAL","code_information":[{"code":"1101000923","type":"CDM"},{"code":"0110","type":"RC"}],"standard_charges":[{"minimum":1465.45,"maximum":2259.005,"gross_charge":2765,"discounted_cash":1106,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2259.01,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE SKIN MUSC AT FX SITE","code_information":[{"code":"11011","type":"CPT"}],"standard_charges":[{"minimum":307.9,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":637.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":307.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":307.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":307.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"DEB SKIN BONE AT FX SITE","code_information":[{"code":"11012","type":"CPT"}],"standard_charges":[{"minimum":433.01,"maximum":2724.13,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":895.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":433.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":433.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":433.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1102","type":"APR-DRG"}],"standard_charges":[{"minimum":5674,"maximum":5674,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5674,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5674,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5674,"methodology":"case rate"}]}]},{"description":"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1103","type":"APR-DRG"}],"standard_charges":[{"minimum":8680,"maximum":8680,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8680,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8680,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8680,"methodology":"case rate"}]}]},{"description":"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1104","type":"APR-DRG"}],"standard_charges":[{"minimum":14780,"maximum":14780,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14780,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14780,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14780,"methodology":"case rate"}]}]},{"description":"DEBR SUBQ TISSUE 1ST 20SQCM","code_information":[{"code":"11042","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":772.21,"maximum":1190.369,"gross_charge":1457,"discounted_cash":582.8,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":772.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1190.37,"methodology":"fee schedule"}]}]},{"description":"DEBR SUBQ TISSUE 1ST 20SQCM","code_information":[{"code":"11042","type":"CPT"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":62.37,"maximum":1190.369,"gross_charge":1457,"discounted_cash":582.8,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":772.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1190.37,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"MOD SED <5Y 1ST 15 OTH MD","code_information":[{"code":"11042","type":"CPT"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":419.23,"maximum":646.247,"gross_charge":791,"discounted_cash":316.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":419.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":646.25,"methodology":"fee schedule"}]}]},{"description":"MOD SED <5Y 1ST 15 OTH MD","code_information":[{"code":"11042","type":"CPT"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":62.37,"maximum":646.247,"gross_charge":791,"discounted_cash":316.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":419.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":646.25,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"XR SPNL PUNC LUMB W FLR OR CT","code_information":[{"code":"11042","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1417.75,"maximum":2185.475,"gross_charge":2675,"discounted_cash":1070,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1417.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2185.48,"methodology":"fee schedule"}]}]},{"description":"XR SPNL PUNC LUMB W FLR OR CT","code_information":[{"code":"11042","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":62.37,"maximum":2185.475,"gross_charge":2675,"discounted_cash":1070,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1417.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2185.48,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"TRACHEOSTOMY PLANNED <2YR","code_information":[{"code":"11043","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":11589.51,"maximum":17865.339,"gross_charge":21867,"discounted_cash":8746.8,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":11589.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":17865.34,"methodology":"fee schedule"}]}]},{"description":"TRACHEOSTOMY PLANNED <2YR","code_information":[{"code":"11043","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":160.08,"maximum":17865.339,"gross_charge":21867,"discounted_cash":8746.8,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":11589.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":17865.34,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"DEB BONE 20 SQ CM/<","code_information":[{"code":"11044","type":"CPT"}],"standard_charges":[{"minimum":234.35,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":484.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"DEBR MUSCLE/FASCIA 1ST 20 SQCM","code_information":[{"code":"11045","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1260.87,"maximum":1943.643,"gross_charge":2379,"discounted_cash":951.6,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1260.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1943.65,"methodology":"fee schedule"}]}]},{"description":"DEBR MUSCLE/FASCIA 1ST 20 SQCM","code_information":[{"code":"11045","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":26.32,"maximum":1943.643,"gross_charge":2379,"discounted_cash":951.6,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1260.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1943.65,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"}]}]},{"description":"DEBR SUBQ TISSUE EA ADD 20SQCM","code_information":[{"code":"11045","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":607.38,"maximum":936.282,"gross_charge":1146,"discounted_cash":458.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":607.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":936.29,"methodology":"fee schedule"}]}]},{"description":"DEBR SUBQ TISSUE EA ADD 20SQCM","code_information":[{"code":"11045","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":26.32,"maximum":936.282,"gross_charge":1146,"discounted_cash":458.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":607.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":936.29,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"}]}]},{"description":"THORACOSTOMY TUBE","code_information":[{"code":"11046","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":3229.29,"maximum":4977.981,"gross_charge":6093,"discounted_cash":2437.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3229.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4977.99,"methodology":"fee schedule"}]}]},{"description":"THORACOSTOMY TUBE","code_information":[{"code":"11046","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":56.97,"maximum":4977.981,"gross_charge":6093,"discounted_cash":2437.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3229.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4977.99,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.97,"methodology":"fee schedule"}]}]},{"description":"DEB BONE ADD-ON","code_information":[{"code":"11047","type":"CPT"}],"standard_charges":[{"minimum":100.59,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":208.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.59,"methodology":"fee schedule"}]}]},{"description":"TRIM SKIN LESION","code_information":[{"code":"11055","type":"CPT"}],"standard_charges":[{"minimum":16.58,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":34.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"TRIM SKIN LESIONS 2 TO 4","code_information":[{"code":"11056","type":"CPT"}],"standard_charges":[{"minimum":23.07,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":47.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"TRIM SKIN LESIONS OVER 4","code_information":[{"code":"11057","type":"CPT"}],"standard_charges":[{"minimum":29.92,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":61.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"TANGNTL BX SKIN SINGLE LES","code_information":[{"code":"11102","type":"CPT"}],"standard_charges":[{"minimum":39.66,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":172.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":172.13,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":172.13,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":81.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"TANGNTL BX SKIN EA SEP/ADDL","code_information":[{"code":"11103","type":"CPT"}],"standard_charges":[{"minimum":22.71,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":99.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":99.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":99.7,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":46.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.71,"methodology":"fee schedule"}]}]},{"description":"PUNCH BX SKIN SINGLE LESION","code_information":[{"code":"11104","type":"CPT"}],"standard_charges":[{"minimum":49.03,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":215.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":215.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":215.98,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":101.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":49.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":49.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":49.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"PUNCH BX SKIN EA SEP/ADDL","code_information":[{"code":"11105","type":"CPT"}],"standard_charges":[{"minimum":26.68,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":117.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":117.81,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":117.81,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":55.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.68,"methodology":"fee schedule"}]}]},{"description":"INCAL BX SKN SINGLE LES","code_information":[{"code":"11106","type":"CPT"}],"standard_charges":[{"minimum":58.77,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":262.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":262.66,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":262.66,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":121.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.77,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"INCAL BX SKN EA SEP/ADDL","code_information":[{"code":"11107","type":"CPT"}],"standard_charges":[{"minimum":32.09,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":140.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":140.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":140.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":66.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.09,"methodology":"fee schedule"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1111","type":"APR-DRG"}],"standard_charges":[{"minimum":3649,"maximum":3649,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3649,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3649,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3649,"methodology":"case rate"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1112","type":"APR-DRG"}],"standard_charges":[{"minimum":4030,"maximum":4030,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4030,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4030,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4030,"methodology":"case rate"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1113","type":"APR-DRG"}],"standard_charges":[{"minimum":5077,"maximum":5077,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5077,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5077,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5077,"methodology":"case rate"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1114","type":"APR-DRG"}],"standard_charges":[{"minimum":6636,"maximum":6636,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6636,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6636,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6636,"methodology":"case rate"}]}]},{"description":"REMOVAL OF SKIN TAGS <W/15","code_information":[{"code":"11200","type":"CPT"}],"standard_charges":[{"minimum":80.04,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":165.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"REMOVE SKIN TAGS ADD-ON","code_information":[{"code":"11201","type":"CPT"}],"standard_charges":[{"minimum":17.31,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":35.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.31,"methodology":"fee schedule"}]}]},{"description":"ORBITAL PROCEDURES WITH CC/MCC","code_information":[{"code":"113","type":"MS-DRG"}],"standard_charges":[{"minimum":17433.94,"maximum":50688.93,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23244.53,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":17433.94,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":17433.94,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":35596.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":35596.14,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":36576.49,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43434,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":35859,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":49359,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":49212.55,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":49704.68,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":50688.93,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":50196.81,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":49212.55,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":49212.55,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":49212.55,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":49704.68,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":49212.55,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 0.5 CM/<","code_information":[{"code":"11300","type":"CPT"}],"standard_charges":[{"minimum":35.69,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":73.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":35.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":35.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":35.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION 0.6-1.0 CM","code_information":[{"code":"11301","type":"CPT"}],"standard_charges":[{"minimum":53.72,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":110.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.72,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION 1.1-2.0 CM","code_information":[{"code":"11302","type":"CPT"}],"standard_charges":[{"minimum":62.37,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":129.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION >2.0 CM","code_information":[{"code":"11303","type":"CPT"}],"standard_charges":[{"minimum":73.91,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":153.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION 0.5 CM/<","code_information":[{"code":"11305","type":"CPT"}],"standard_charges":[{"minimum":39.3,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":81.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION 0.6-1.0 CM","code_information":[{"code":"11306","type":"CPT"}],"standard_charges":[{"minimum":51.56,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":106.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION 1.1-2.0 CM","code_information":[{"code":"11307","type":"CPT"}],"standard_charges":[{"minimum":65.62,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":135.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.62,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.62,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION >2.0 CM","code_information":[{"code":"11308","type":"CPT"}],"standard_charges":[{"minimum":73.19,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":151.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1131","type":"APR-DRG"}],"standard_charges":[{"minimum":2300,"maximum":2300,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2300,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2300,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2300,"methodology":"case rate"}]}]},{"description":"SHAVE SKIN LESION 0.5 CM/<","code_information":[{"code":"11310","type":"CPT"}],"standard_charges":[{"minimum":47.95,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":99.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION 0.6-1.0 CM","code_information":[{"code":"11311","type":"CPT"}],"standard_charges":[{"minimum":65.62,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":135.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.62,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.62,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION 1.1-2.0 CM","code_information":[{"code":"11312","type":"CPT"}],"standard_charges":[{"minimum":78.6,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":162.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":78.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":78.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":78.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"SHAVE SKIN LESION >2.0 CM","code_information":[{"code":"11313","type":"CPT"}],"standard_charges":[{"minimum":99.87,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":206.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1132","type":"APR-DRG"}],"standard_charges":[{"minimum":3194,"maximum":3194,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3194,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3194,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3194,"methodology":"case rate"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1133","type":"APR-DRG"}],"standard_charges":[{"minimum":4672,"maximum":4672,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4672,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4672,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4672,"methodology":"case rate"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1134","type":"APR-DRG"}],"standard_charges":[{"minimum":8946,"maximum":8946,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8946,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8946,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8946,"methodology":"case rate"}]}]},{"description":"ORBITAL PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"114","type":"MS-DRG"}],"standard_charges":[{"minimum":12686.63,"maximum":41077.06,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16914.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12686.63,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12686.63,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17487.86,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":17487.86,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17969.5,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21338,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17617,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":24249,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39880.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40279.45,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41077.06,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40678.26,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39880.64,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39880.64,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39880.64,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40279.45,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39880.64,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT B9+MARG 0.5 CM<","code_information":[{"code":"11400","type":"CPT"}],"standard_charges":[{"minimum":87.97,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":181.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT B9+MARG 0.6-1 CM","code_information":[{"code":"11401","type":"CPT"}],"standard_charges":[{"minimum":111.05,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":229.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT B9+MARG 1.1-2 CM","code_information":[{"code":"11402","type":"CPT"}],"standard_charges":[{"minimum":121.14,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":250.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT B9+MARG 2.1-3CM","code_information":[{"code":"11403","type":"CPT"}],"standard_charges":[{"minimum":155.75,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":322.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT B9+MARG 3.1-4 CM","code_information":[{"code":"11404","type":"CPT"}],"standard_charges":[{"minimum":171.98,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":355.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":171.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":171.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":171.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT B9+MARG >4.0 CM","code_information":[{"code":"11406","type":"CPT"}],"standard_charges":[{"minimum":258.87,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":535.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":258.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":258.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":258.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1141","type":"APR-DRG"}],"standard_charges":[{"minimum":2705,"maximum":2705,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2705,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2705,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2705,"methodology":"case rate"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1142","type":"APR-DRG"}],"standard_charges":[{"minimum":3681,"maximum":3681,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3681,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3681,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3681,"methodology":"case rate"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 0.5/<","code_information":[{"code":"11420","type":"CPT"}],"standard_charges":[{"minimum":86.17,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":177.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 0.6-1","code_information":[{"code":"11421","type":"CPT"}],"standard_charges":[{"minimum":114.65,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":237.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 1.1-2","code_information":[{"code":"11422","type":"CPT"}],"standard_charges":[{"minimum":142.05,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":293.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 2.1-3","code_information":[{"code":"11423","type":"CPT"}],"standard_charges":[{"minimum":163.32,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":338.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 3.1-4","code_information":[{"code":"11424","type":"CPT"}],"standard_charges":[{"minimum":186.76,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":385.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC H-F-NK-SP B9+MARG >4 CM","code_information":[{"code":"11426","type":"CPT"}],"standard_charges":[{"minimum":281.94,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":583.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":281.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":281.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":281.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1143","type":"APR-DRG"}],"standard_charges":[{"minimum":6192,"maximum":6192,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6192,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6192,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6192,"methodology":"case rate"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1144","type":"APR-DRG"}],"standard_charges":[{"minimum":15116,"maximum":15116,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15116,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15116,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15116,"methodology":"case rate"}]}]},{"description":"EXC FACE-MM B9+MARG 0.5 CM/<","code_information":[{"code":"11440","type":"CPT"}],"standard_charges":[{"minimum":111.05,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":229.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC FACE-MM B9+MARG 0.6-1 CM","code_information":[{"code":"11441","type":"CPT"}],"standard_charges":[{"minimum":139.17,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":287.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":139.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":139.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":139.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC FACE-MM B9+MARG 1.1-2 CM","code_information":[{"code":"11442","type":"CPT"}],"standard_charges":[{"minimum":153.59,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":317.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC FACE-MM B9+MARG 2.1-3 CM","code_information":[{"code":"11443","type":"CPT"}],"standard_charges":[{"minimum":187.12,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":386.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":187.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":187.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":187.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC FACE-MM B9+MARG 3.1-4 CM","code_information":[{"code":"11444","type":"CPT"}],"standard_charges":[{"minimum":235.79,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":487.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":235.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":235.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":235.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC FACE-MM B9+MARG >4 CM","code_information":[{"code":"11446","type":"CPT"}],"standard_charges":[{"minimum":330.61,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":683.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":330.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":330.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":330.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11450","type":"CPT"}],"standard_charges":[{"minimum":274.01,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":566.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":274.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":274.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":274.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11451","type":"CPT"}],"standard_charges":[{"minimum":347.56,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":719,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11462","type":"CPT"}],"standard_charges":[{"minimum":259.95,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":537.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":259.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":259.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":259.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11463","type":"CPT"}],"standard_charges":[{"minimum":349.72,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":723.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.72,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11470","type":"CPT"}],"standard_charges":[{"minimum":301.41,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":623.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":301.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":301.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":301.41,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVAL SWEAT GLAND LESION","code_information":[{"code":"11471","type":"CPT"}],"standard_charges":[{"minimum":366.67,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":758.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":366.67,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":366.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":366.67,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXTRAOCULAR PROCEDURES EXCEPT ORBIT","code_information":[{"code":"115","type":"MS-DRG"}],"standard_charges":[{"minimum":13035.97,"maximum":43583.47,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17380.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13035.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13035.97,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22209.79,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":22209.79,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22821.47,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27100,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22374,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":30797,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42314.04,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42737.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43583.47,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43160.33,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42314.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42314.04,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42314.04,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42737.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42314.04,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1151","type":"APR-DRG"}],"standard_charges":[{"minimum":3262,"maximum":3262,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3262,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3262,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1152","type":"APR-DRG"}],"standard_charges":[{"minimum":4340,"maximum":4340,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4340,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4340,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4340,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1153","type":"APR-DRG"}],"standard_charges":[{"minimum":6831,"maximum":6831,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6831,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6831,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6831,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1154","type":"APR-DRG"}],"standard_charges":[{"minimum":12897,"maximum":12897,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12897,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12897,"methodology":"case rate"}]}]},{"description":"INTRAOCULAR PROCEDURES WITH CC/MCC","code_information":[{"code":"116","type":"MS-DRG"}],"standard_charges":[{"minimum":13105.37,"maximum":45590.99,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17473.27,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13105.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13105.37,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25991.87,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25991.87,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":26707.71,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31715,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":26184,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":36041,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44263.09,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44705.73,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45590.99,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45148.36,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44263.09,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44263.09,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44263.09,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44705.73,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44263.09,"methodology":"case rate"}]}]},{"description":"EXC TR-EXT MAL+MARG 0.5 CM/<","code_information":[{"code":"11600","type":"CPT"}],"standard_charges":[{"minimum":127.63,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":264.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT MAL+MARG 0.6-1 CM","code_information":[{"code":"11601","type":"CPT"}],"standard_charges":[{"minimum":155.03,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":320.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT MAL+MARG 1.1-2 CM","code_information":[{"code":"11602","type":"CPT"}],"standard_charges":[{"minimum":168.37,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":348.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT MAL+MARG 2.1-3 CM","code_information":[{"code":"11603","type":"CPT"}],"standard_charges":[{"minimum":201.54,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":417.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":201.54,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":201.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":201.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT MAL+MARG 3.1-4 CM","code_information":[{"code":"11604","type":"CPT"}],"standard_charges":[{"minimum":222.09,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":459.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":222.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":222.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":222.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC TR-EXT MAL+MARG >4 CM","code_information":[{"code":"11606","type":"CPT"}],"standard_charges":[{"minimum":329.53,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":681.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":329.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":329.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":329.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC H-F-NK-SP MAL+MARG 0.5/<","code_information":[{"code":"11620","type":"CPT"}],"standard_charges":[{"minimum":128.35,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":265.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":128.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":128.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":128.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 0.6-1","code_information":[{"code":"11621","type":"CPT"}],"standard_charges":[{"minimum":155.75,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":322.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 1.1-2","code_information":[{"code":"11622","type":"CPT"}],"standard_charges":[{"minimum":176.3,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":364.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 2.1-3","code_information":[{"code":"11623","type":"CPT"}],"standard_charges":[{"minimum":218.49,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":451.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG 3.1-4","code_information":[{"code":"11624","type":"CPT"}],"standard_charges":[{"minimum":248.05,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":512.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":248.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":248.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":248.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC S/N/H/F/G MAL+MRG >4 CM","code_information":[{"code":"11626","type":"CPT"}],"standard_charges":[{"minimum":303.93,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":628.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":303.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":303.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":303.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 0.5CM<","code_information":[{"code":"11640","type":"CPT"}],"standard_charges":[{"minimum":131.96,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":272.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":131.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":131.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":131.96,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 0.6-1","code_information":[{"code":"11641","type":"CPT"}],"standard_charges":[{"minimum":162.24,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":335.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 1.1-2","code_information":[{"code":"11642","type":"CPT"}],"standard_charges":[{"minimum":189.28,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":391.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.28,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 2.1-3","code_information":[{"code":"11643","type":"CPT"}],"standard_charges":[{"minimum":236.87,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":489.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":236.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":236.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":236.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG 3.1-4","code_information":[{"code":"11644","type":"CPT"}],"standard_charges":[{"minimum":293.84,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":607.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.84,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC F/E/E/N/L MAL+MRG >4 CM","code_information":[{"code":"11646","type":"CPT"}],"standard_charges":[{"minimum":406.33,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":840.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":406.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":406.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":406.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"INTRAOCULAR PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"117","type":"MS-DRG"}],"standard_charges":[{"minimum":10456.54,"maximum":40825.37,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13941.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10456.54,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10456.54,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17013.68,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":17013.68,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17482.26,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20760,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17140,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":23592,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39636.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40032.65,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40825.37,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40429.01,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39636.28,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39636.28,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39636.28,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40032.65,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39636.28,"methodology":"case rate"}]}]},{"description":"TRIM NAIL(S) ANY NUMBER","code_information":[{"code":"11719","type":"CPT"}],"standard_charges":[{"minimum":7.93,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":59.44,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":60.62,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":60.03,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":59.44,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE NAIL 1-5","code_information":[{"code":"11720","type":"CPT"}],"standard_charges":[{"minimum":15.14,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":31.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":59.44,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":60.62,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":60.03,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":59.44,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE NAIL 6 OR MORE","code_information":[{"code":"11721","type":"CPT"}],"standard_charges":[{"minimum":24.88,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":51.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.88,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":59.44,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":60.62,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":60.03,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":59.44,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":58.85,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF NAIL PLATE","code_information":[{"code":"11730","type":"CPT"}],"standard_charges":[{"minimum":56.24,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":116.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"REMOVE NAIL PLATE ADD-ON","code_information":[{"code":"11732","type":"CPT"}],"standard_charges":[{"minimum":18.03,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":103.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":103.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":18.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":18.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":18.03,"methodology":"fee schedule"}]}]},{"description":"DRAIN BLOOD FROM UNDER NAIL","code_information":[{"code":"11740","type":"CPT"}],"standard_charges":[{"minimum":33.17,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":105.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":105.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":105.55,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":68.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":120.07,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":122.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":121.26,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":120.07,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF NAIL BED","code_information":[{"code":"11750","type":"CPT"}],"standard_charges":[{"minimum":105.28,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":218.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"BIOPSY NAIL UNIT","code_information":[{"code":"11755","type":"CPT"}],"standard_charges":[{"minimum":63.45,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":131.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.45,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"REPAIR OF NAIL BED","code_information":[{"code":"11760","type":"CPT"}],"standard_charges":[{"minimum":115.73,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":239.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.73,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.73,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF NAIL BED","code_information":[{"code":"11762","type":"CPT"}],"standard_charges":[{"minimum":195.41,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":404.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":195.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":195.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":195.41,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"EXCISION OF NAIL FOLD TOE","code_information":[{"code":"11765","type":"CPT"}],"standard_charges":[{"minimum":96.26,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":199.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"REMOVE PILONIDAL CYST SIMPLE","code_information":[{"code":"11770","type":"CPT"}],"standard_charges":[{"minimum":193.97,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":401.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE PILONIDAL CYST EXTEN","code_information":[{"code":"11771","type":"CPT"}],"standard_charges":[{"minimum":470.86,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":973.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":470.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":470.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":470.86,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE PILONIDAL CYST COMPL","code_information":[{"code":"11772","type":"CPT"}],"standard_charges":[{"minimum":607.15,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1255.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":607.15,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":607.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":607.15,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"INJECT SKIN LESIONS </W 7","code_information":[{"code":"11900","type":"CPT"}],"standard_charges":[{"minimum":31.37,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":64.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"INJECT SKIN LESIONS >7","code_information":[{"code":"11901","type":"CPT"}],"standard_charges":[{"minimum":47.59,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":98.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"CORRECT SKIN COLOR 6.0 CM/<","code_information":[{"code":"11920","type":"CPT"}],"standard_charges":[{"minimum":113.57,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":234.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CORRECT SKN COLOR 6.1-20.0CM","code_information":[{"code":"11921","type":"CPT"}],"standard_charges":[{"minimum":136.64,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":282.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CORRECT SKIN COLOR EA 20.0CM","code_information":[{"code":"11922","type":"CPT"}],"standard_charges":[{"minimum":63.01,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":63.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TX CONTOUR DEFECTS 1 CC/<","code_information":[{"code":"11950","type":"CPT"}],"standard_charges":[{"minimum":112.95,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":112.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"TX CONTOUR DEFECTS 1.1-5.0CC","code_information":[{"code":"11951","type":"CPT"}],"standard_charges":[{"minimum":157.3,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":157.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"TX CONTOUR DEFECTS 5.1-10CC","code_information":[{"code":"11952","type":"CPT"}],"standard_charges":[{"minimum":220.51,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":220.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"TX CONTOUR DEFECTS >10.0 CC","code_information":[{"code":"11954","type":"CPT"}],"standard_charges":[{"minimum":241.43,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":241.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"INSERT TISSUE EXPANDER(S)","code_information":[{"code":"11960","type":"CPT"}],"standard_charges":[{"minimum":1062.14,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2196.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REPLACE TISSUE EXPANDER","code_information":[{"code":"11970","type":"CPT"}],"standard_charges":[{"minimum":589.12,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1218.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":589.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":589.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":589.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE TISSUE EXPANDER(S)","code_information":[{"code":"11971","type":"CPT"}],"standard_charges":[{"minimum":578.3,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1195.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":578.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":578.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":578.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE CONTRACEPTIVE CAPSULE","code_information":[{"code":"11976","type":"CPT"}],"standard_charges":[{"minimum":96.98,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1129.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1129.54,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1129.54,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":200.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"IMPLANT HORMONE PELLET(S)","code_information":[{"code":"11980","type":"CPT"}],"standard_charges":[{"minimum":58.41,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":120.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.41,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":398.16,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":394.3,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"}]}]},{"description":"INSERT DRUG IMPLANT DEVICE","code_information":[{"code":"11981","type":"CPT"}],"standard_charges":[{"minimum":65.26,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":135.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":120.07,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":122.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":121.26,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":120.07,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":118.88,"methodology":"fee schedule"}]}]},{"description":"REMOVE DRUG IMPLANT DEVICE","code_information":[{"code":"11982","type":"CPT"}],"standard_charges":[{"minimum":77.16,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":159.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":398.16,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":394.3,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE/INSERT DRUG IMPLANT","code_information":[{"code":"11983","type":"CPT"}],"standard_charges":[{"minimum":108.16,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":223.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":398.16,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":394.3,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"}]}]},{"description":"RPR S/N/AX/GEN/TRNK 2.5CM/<","code_information":[{"code":"12001","type":"CPT"}],"standard_charges":[{"minimum":46.87,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":97.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RPR S/N/AX/GEN/TRNK2.6-7.5CM","code_information":[{"code":"12002","type":"CPT"}],"standard_charges":[{"minimum":61.29,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":127.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RPR S/N/AX/GEN/TRK7.6-12.5CM","code_information":[{"code":"12004","type":"CPT"}],"standard_charges":[{"minimum":76.07,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":157.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RPR S/N/A/GEN/TRK12.6-20.0CM","code_information":[{"code":"12005","type":"CPT"}],"standard_charges":[{"minimum":98.79,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":204.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"RPR S/N/A/GEN/TRK20.1-30.0CM","code_information":[{"code":"12006","type":"CPT"}],"standard_charges":[{"minimum":121.5,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":251.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.5,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.5,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"RPR S/N/AX/GEN/TRNK >30.0 CM","code_information":[{"code":"12007","type":"CPT"}],"standard_charges":[{"minimum":151.07,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":312.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1201","type":"APR-DRG"}],"standard_charges":[{"minimum":10919,"maximum":10919,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10919,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10919,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10919,"methodology":"case rate"}]}]},{"description":"ROOM SEMI GENERAL","code_information":[{"code":"1201000924","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":1465.45,"maximum":2259.005,"gross_charge":2765,"discounted_cash":1106,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1465.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2259.01,"methodology":"fee schedule"}]}]},{"description":"RPR F/E/E/N/L/M 2.5 CM/<","code_information":[{"code":"12011","type":"CPT"}],"standard_charges":[{"minimum":57.69,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":119.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RPR F/E/E/N/L/M 2.6-5.0 CM","code_information":[{"code":"12013","type":"CPT"}],"standard_charges":[{"minimum":60.93,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":126.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RPR F/E/E/N/L/M 5.1-7.5 CM","code_information":[{"code":"12014","type":"CPT"}],"standard_charges":[{"minimum":77.88,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":161.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.88,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RPR F/E/E/N/L/M 7.6-12.5 CM","code_information":[{"code":"12015","type":"CPT"}],"standard_charges":[{"minimum":98.43,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":203.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RPR FE/E/EN/L/M 12.6-20.0 CM","code_information":[{"code":"12016","type":"CPT"}],"standard_charges":[{"minimum":133.4,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":276.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":133.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":133.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":133.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"RPR FE/E/EN/L/M 20.1-30.0 CM","code_information":[{"code":"12017","type":"CPT"}],"standard_charges":[{"minimum":160.44,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":331.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"RPR F/E/E/N/L/M >30.0 CM","code_information":[{"code":"12018","type":"CPT"}],"standard_charges":[{"minimum":180.99,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":331.19,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":374.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":180.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":180.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":180.99,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1202","type":"APR-DRG"}],"standard_charges":[{"minimum":13550,"maximum":13550,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13550,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13550,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13550,"methodology":"case rate"}]}]},{"description":"CLOSURE OF SPLIT WOUND","code_information":[{"code":"12020","type":"CPT"}],"standard_charges":[{"minimum":196.85,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":407.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":196.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":196.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":196.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CLOSURE OF SPLIT WOUND","code_information":[{"code":"12021","type":"CPT"}],"standard_charges":[{"minimum":147.46,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":305.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":147.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":147.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":147.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1203","type":"APR-DRG"}],"standard_charges":[{"minimum":20637,"maximum":20637,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":20637,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":20637,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":20637,"methodology":"case rate"}]}]},{"description":"INTMD RPR S/A/T/EXT 2.5 CM/<","code_information":[{"code":"12031","type":"CPT"}],"standard_charges":[{"minimum":158.28,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":327.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.28,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR S/A/T/EXT 2.6-7.5","code_information":[{"code":"12032","type":"CPT"}],"standard_charges":[{"minimum":197.94,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":409.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":197.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":197.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":197.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR S/TR/EXT 7.6-12.5","code_information":[{"code":"12034","type":"CPT"}],"standard_charges":[{"minimum":214.16,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":442.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR S/A/T/EXT 12.6-20","code_information":[{"code":"12035","type":"CPT"}],"standard_charges":[{"minimum":251.29,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":519.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":251.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":251.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":251.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR S/A/T/EXT 20.1-30","code_information":[{"code":"12036","type":"CPT"}],"standard_charges":[{"minimum":293.48,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":606.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR S/TR/EXT >30.0 CM","code_information":[{"code":"12037","type":"CPT"}],"standard_charges":[{"minimum":341.07,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":704.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":341.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":341.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":341.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1204","type":"APR-DRG"}],"standard_charges":[{"minimum":36118,"maximum":36118,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":36118,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":36118,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":36118,"methodology":"case rate"}]}]},{"description":"INTMD RPR N-HF/GENIT 2.5CM/<","code_information":[{"code":"12041","type":"CPT"}],"standard_charges":[{"minimum":151.43,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":313.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR N-HF/GENIT2.6-7.5","code_information":[{"code":"12042","type":"CPT"}],"standard_charges":[{"minimum":204.06,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":421.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":204.06,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":204.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":204.06,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR N-HF/GENIT7.6-12.5","code_information":[{"code":"12044","type":"CPT"}],"standard_charges":[{"minimum":223.17,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":461.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR N-HF/GENIT12.6-20","code_information":[{"code":"12045","type":"CPT"}],"standard_charges":[{"minimum":286.63,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":592.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR N-HF/GENIT20.1-30","code_information":[{"code":"12046","type":"CPT"}],"standard_charges":[{"minimum":330.97,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":684.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":330.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":330.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":330.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR N-HF/GENIT >30.0CM","code_information":[{"code":"12047","type":"CPT"}],"standard_charges":[{"minimum":368.11,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":761,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.11,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.11,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR FACE/MM 2.5 CM/<","code_information":[{"code":"12051","type":"CPT"}],"standard_charges":[{"minimum":177.02,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":365.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":177.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":177.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":177.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR FACE/MM 2.6-5.0 CM","code_information":[{"code":"12052","type":"CPT"}],"standard_charges":[{"minimum":208.39,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":430.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":208.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":208.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":208.39,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR FACE/MM 5.1-7.5 CM","code_information":[{"code":"12053","type":"CPT"}],"standard_charges":[{"minimum":224.98,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":464.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR FACE/MM 7.6-12.5CM","code_information":[{"code":"12054","type":"CPT"}],"standard_charges":[{"minimum":229.66,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":474.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":229.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":229.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":229.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR FACE/MM 12.6-20 CM","code_information":[{"code":"12055","type":"CPT"}],"standard_charges":[{"minimum":313.31,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":647.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":313.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":313.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":313.31,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR FACE/MM 20.1-30.0","code_information":[{"code":"12056","type":"CPT"}],"standard_charges":[{"minimum":381.96,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":830.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":401.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":401.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":401.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INTMD RPR FACE/MM >30.0 CM","code_information":[{"code":"12057","type":"CPT"}],"standard_charges":[{"minimum":381.96,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":905.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":437.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":437.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":437.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"ACUTE MAJOR EYE INFECTIONS WITH CC/MCC","code_information":[{"code":"121","type":"MS-DRG"}],"standard_charges":[{"minimum":11097.81,"maximum":41449.34,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14796.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11097.81,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11097.81,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18189.2,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18189.2,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":18690.15,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22194,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":18324,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":25222,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40242.07,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40644.5,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41449.34,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41046.92,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40242.07,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40242.07,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40242.07,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40644.5,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40242.07,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1211","type":"APR-DRG"}],"standard_charges":[{"minimum":8077,"maximum":8077,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8077,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8077,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8077,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1212","type":"APR-DRG"}],"standard_charges":[{"minimum":10983,"maximum":10983,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10983,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10983,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10983,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1213","type":"APR-DRG"}],"standard_charges":[{"minimum":17097,"maximum":17097,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17097,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17097,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17097,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1214","type":"APR-DRG"}],"standard_charges":[{"minimum":29557,"maximum":29557,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":29557,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":29557,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":29557,"methodology":"case rate"}]}]},{"description":"ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC","code_information":[{"code":"122","type":"MS-DRG"}],"standard_charges":[{"minimum":8334.12,"maximum":37404.89,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11111.81,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8334.12,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8334.12,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10569.67,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10569.67,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10860.77,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":10648,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14656,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36315.42,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36678.58,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37404.89,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37041.73,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36315.42,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36315.42,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36315.42,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36678.58,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36315.42,"methodology":"case rate"}]}]},{"description":"NEUROLOGICAL EYE DISORDERS","code_information":[{"code":"123","type":"MS-DRG"}],"standard_charges":[{"minimum":11414.39,"maximum":37853.27,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17470.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13102.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13102.97,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11414.39,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11414.39,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11728.75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15496,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17747,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":11499,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36750.74,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37118.25,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37853.27,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37485.76,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36750.74,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36750.74,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36750.74,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37118.25,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36750.74,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT","code_information":[{"code":"124","type":"MS-DRG"}],"standard_charges":[{"minimum":10458.93,"maximum":41756.04,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13944.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10458.93,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10458.93,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18767.01,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18767.01,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19283.88,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22899,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":18906,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":26023,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40539.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40945.24,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41756.04,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41350.64,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40539.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40539.84,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40539.84,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40945.24,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40539.84,"methodology":"case rate"}]}]},{"description":"OTHER DISORDERS OF THE EYE WITHOUT MCC","code_information":[{"code":"125","type":"MS-DRG"}],"standard_charges":[{"minimum":7630.64,"maximum":37804.29,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10173.87,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7630.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7630.64,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11322.11,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11322.11,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11633.93,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13815,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":11406,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":15700,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36703.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37070.23,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37804.29,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37437.26,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36703.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36703.19,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36703.19,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37070.23,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36703.19,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1301","type":"APR-DRG"}],"standard_charges":[{"minimum":18134,"maximum":18134,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":18134,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":18134,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":18134,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1302","type":"APR-DRG"}],"standard_charges":[{"minimum":21538,"maximum":21538,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":21538,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":21538,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":21538,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1303","type":"APR-DRG"}],"standard_charges":[{"minimum":25327,"maximum":25327,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25327,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25327,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25327,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1304","type":"APR-DRG"}],"standard_charges":[{"minimum":33998,"maximum":33998,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":33998,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":33998,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":33998,"methodology":"case rate"}]}]},{"description":"CMPLX RPR TRUNK 1.1-2.5 CM","code_information":[{"code":"13100","type":"CPT"}],"standard_charges":[{"minimum":209.11,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":432.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":209.11,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":209.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":209.11,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR TRUNK 2.6-7.5 CM","code_information":[{"code":"13101","type":"CPT"}],"standard_charges":[{"minimum":257.78,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":533.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":257.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":257.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":257.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR TRUNK ADDL 5CM/<","code_information":[{"code":"13102","type":"CPT"}],"standard_charges":[{"minimum":74.63,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":154.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.63,"methodology":"fee schedule"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1311","type":"APR-DRG"}],"standard_charges":[{"minimum":7929,"maximum":7929,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7929,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7929,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7929,"methodology":"case rate"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1312","type":"APR-DRG"}],"standard_charges":[{"minimum":9764,"maximum":9764,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9764,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9764,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9764,"methodology":"case rate"}]}]},{"description":"CMPLX RPR S/A/L 1.1-2.5 CM","code_information":[{"code":"13120","type":"CPT"}],"standard_charges":[{"minimum":241.92,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":500.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":241.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":241.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":241.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR S/A/L 2.6-7.5 CM","code_information":[{"code":"13121","type":"CPT"}],"standard_charges":[{"minimum":268.24,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":554.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":268.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":268.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":268.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR S/A/L ADDL 5 CM/>","code_information":[{"code":"13122","type":"CPT"}],"standard_charges":[{"minimum":86.17,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":178.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.17,"methodology":"fee schedule"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1313","type":"APR-DRG"}],"standard_charges":[{"minimum":13265,"maximum":13265,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13265,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13265,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13265,"methodology":"case rate"}]}]},{"description":"CMPLX RPR F/C/C/M/N/AX/G/H/F","code_information":[{"code":"13131","type":"CPT"}],"standard_charges":[{"minimum":252.02,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":520.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR F/C/C/M/N/AX/G/H/F","code_information":[{"code":"13132","type":"CPT"}],"standard_charges":[{"minimum":315.83,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":652.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":315.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":315.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":315.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR F/C/C/M/N/AX/G/H/F","code_information":[{"code":"13133","type":"CPT"}],"standard_charges":[{"minimum":130.15,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":268.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.15,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.15,"methodology":"fee schedule"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1314","type":"APR-DRG"}],"standard_charges":[{"minimum":17604,"maximum":17604,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17604,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17604,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17604,"methodology":"case rate"}]}]},{"description":"CMPLX RPR E/N/E/L 1.1-2.5 CM","code_information":[{"code":"13151","type":"CPT"}],"standard_charges":[{"minimum":290.23,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":599.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":290.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":290.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":290.23,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR E/N/E/L 2.6-7.5 CM","code_information":[{"code":"13152","type":"CPT"}],"standard_charges":[{"minimum":349.72,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":723.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.72,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CMPLX RPR E/N/E/L ADDL 5CM/<","code_information":[{"code":"13153","type":"CPT"}],"standard_charges":[{"minimum":142.41,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":294.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.41,"methodology":"fee schedule"}]}]},{"description":"LATE CLOSURE OF WOUND","code_information":[{"code":"13160","type":"CPT"}],"standard_charges":[{"minimum":832.84,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1721.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":832.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":832.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":832.84,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1321","type":"APR-DRG"}],"standard_charges":[{"minimum":3018,"maximum":3018,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3018,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3018,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3018,"methodology":"case rate"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1322","type":"APR-DRG"}],"standard_charges":[{"minimum":4001,"maximum":4001,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4001,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4001,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4001,"methodology":"case rate"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1323","type":"APR-DRG"}],"standard_charges":[{"minimum":6682,"maximum":6682,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6682,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6682,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6682,"methodology":"case rate"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1324","type":"APR-DRG"}],"standard_charges":[{"minimum":11625,"maximum":11625,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11625,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11625,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11625,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1331","type":"APR-DRG"}],"standard_charges":[{"minimum":2669,"maximum":2669,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2669,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2669,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1332","type":"APR-DRG"}],"standard_charges":[{"minimum":4405,"maximum":4405,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4405,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4405,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4405,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1333","type":"APR-DRG"}],"standard_charges":[{"minimum":6733,"maximum":6733,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6733,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6733,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6733,"methodology":"case rate"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1334","type":"APR-DRG"}],"standard_charges":[{"minimum":11816,"maximum":11816,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11816,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11816,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1341","type":"APR-DRG"}],"standard_charges":[{"minimum":3584,"maximum":3584,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3584,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3584,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3584,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1342","type":"APR-DRG"}],"standard_charges":[{"minimum":4755,"maximum":4755,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4755,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4755,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4755,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1343","type":"APR-DRG"}],"standard_charges":[{"minimum":7088,"maximum":7088,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7088,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7088,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7088,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1344","type":"APR-DRG"}],"standard_charges":[{"minimum":10836,"maximum":10836,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10836,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10836,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10836,"methodology":"case rate"}]}]},{"description":"SINUS AND MASTOID PROCEDURES WITH CC/MCC","code_information":[{"code":"135","type":"MS-DRG"}],"standard_charges":[{"minimum":20786.25,"maximum":52209,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27714.14,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":20786.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":20786.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37651.86,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":37651.86,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":38688.83,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45942,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":37930,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":52209,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":50271.95,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":50774.67,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":51780.11,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":51277.39,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":50271.95,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":50271.95,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":50271.95,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":50774.67,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":50271.95,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1351","type":"APR-DRG"}],"standard_charges":[{"minimum":4597,"maximum":4597,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4597,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4597,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4597,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1352","type":"APR-DRG"}],"standard_charges":[{"minimum":5377,"maximum":5377,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5377,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5377,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5377,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1353","type":"APR-DRG"}],"standard_charges":[{"minimum":7631,"maximum":7631,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7631,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7631,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7631,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1354","type":"APR-DRG"}],"standard_charges":[{"minimum":13231,"maximum":13231,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13231,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13231,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13231,"methodology":"case rate"}]}]},{"description":"SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"136","type":"MS-DRG"}],"standard_charges":[{"minimum":14825.93,"maximum":39664.11,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20070.18,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15053.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15053.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14825.93,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14825.93,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":15234.25,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18090,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":14936,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":20558,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38508.84,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38893.93,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39664.11,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39279.02,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38508.84,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38508.84,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38508.84,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38893.93,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38508.84,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1361","type":"APR-DRG"}],"standard_charges":[{"minimum":4492,"maximum":4492,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4492,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4492,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4492,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1362","type":"APR-DRG"}],"standard_charges":[{"minimum":5877,"maximum":5877,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5877,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5877,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5877,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1363","type":"APR-DRG"}],"standard_charges":[{"minimum":8333,"maximum":8333,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8333,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8333,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8333,"methodology":"case rate"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1364","type":"APR-DRG"}],"standard_charges":[{"minimum":12324,"maximum":12324,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12324,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12324,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12324,"methodology":"case rate"}]}]},{"description":"MOUTH PROCEDURES WITH CC/MCC","code_information":[{"code":"137","type":"MS-DRG"}],"standard_charges":[{"minimum":15859.48,"maximum":43133.58,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21145.31,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15859.48,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15859.48,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21362.23,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21362.23,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":21950.56,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26066,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":21520,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":29622,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41877.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42296.04,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43133.58,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42714.81,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41877.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41877.26,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41877.26,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42296.04,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41877.26,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1371","type":"APR-DRG"}],"standard_charges":[{"minimum":3794,"maximum":3794,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3794,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3794,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3794,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1372","type":"APR-DRG"}],"standard_charges":[{"minimum":4970,"maximum":4970,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4970,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4970,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4970,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1373","type":"APR-DRG"}],"standard_charges":[{"minimum":7008,"maximum":7008,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7008,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7008,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7008,"methodology":"case rate"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1374","type":"APR-DRG"}],"standard_charges":[{"minimum":10298,"maximum":10298,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10298,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10298,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10298,"methodology":"case rate"}]}]},{"description":"MOUTH PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"138","type":"MS-DRG"}],"standard_charges":[{"minimum":10600.1,"maximum":38318.23,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14133.03,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10600.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10600.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12290.34,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12290.34,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12628.83,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14997,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":12381,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":17042,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37202.16,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37574.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38318.23,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37946.21,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37202.16,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37202.16,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37202.16,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37574.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37202.16,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1381","type":"APR-DRG"}],"standard_charges":[{"minimum":2045,"maximum":2045,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2045,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2045,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2045,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1382","type":"APR-DRG"}],"standard_charges":[{"minimum":3040,"maximum":3040,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3040,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3040,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3040,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1383","type":"APR-DRG"}],"standard_charges":[{"minimum":5157,"maximum":5157,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5157,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5157,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5157,"methodology":"case rate"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1384","type":"APR-DRG"}],"standard_charges":[{"minimum":12058,"maximum":12058,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12058,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12058,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12058,"methodology":"case rate"}]}]},{"description":"SALIVARY GLAND PROCEDURES","code_information":[{"code":"139","type":"MS-DRG"}],"standard_charges":[{"minimum":11640.97,"maximum":40744.74,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15520.81,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11640.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11640.97,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16861.78,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":16861.78,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17326.17,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20575,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":16986,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":23381,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39558,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39953.58,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40744.74,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40349.16,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39558,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39558,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39558,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39953.58,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39558,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1391","type":"APR-DRG"}],"standard_charges":[{"minimum":2833,"maximum":2833,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2833,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2833,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2833,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1392","type":"APR-DRG"}],"standard_charges":[{"minimum":3816,"maximum":3816,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3816,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3816,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1393","type":"APR-DRG"}],"standard_charges":[{"minimum":5461,"maximum":5461,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5461,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5461,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5461,"methodology":"case rate"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1394","type":"APR-DRG"}],"standard_charges":[{"minimum":8747,"maximum":8747,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8747,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8747,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8747,"methodology":"case rate"}]}]},{"description":"MAJOR HEAD AND NECK PROCEDURES WITH MCC","code_information":[{"code":"140","type":"MS-DRG"}],"standard_charges":[{"minimum":48018.71,"maximum":74376,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":64022.94,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":48018.71,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":48018.71,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53637.69,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":53637.69,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":55114.92,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65448,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":54034,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":74376,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":58510.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":59095.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":60265.39,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":59680.29,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":58510.08,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":58510.08,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":58510.08,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":59095.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":58510.08,"methodology":"case rate"}]}]},{"description":"TIS TRNFR TRUNK 10 SQ CM/<","code_information":[{"code":"14000","type":"CPT"}],"standard_charges":[{"minimum":525.66,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1087.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":525.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":525.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":525.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"TIS TRNFR TRUNK 10.1-30SQCM","code_information":[{"code":"14001","type":"CPT"}],"standard_charges":[{"minimum":681.42,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1409.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":681.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":681.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":681.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1401","type":"APR-DRG"}],"standard_charges":[{"minimum":3250,"maximum":3250,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3250,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3250,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3250,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1402","type":"APR-DRG"}],"standard_charges":[{"minimum":4059,"maximum":4059,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4059,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4059,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4059,"methodology":"case rate"}]}]},{"description":"TIS TRNFR S/A/L 10 SQ CM/<","code_information":[{"code":"14020","type":"CPT"}],"standard_charges":[{"minimum":590.56,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1221.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":590.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":590.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":590.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"TIS TRNFR S/A/L 10.1-30 SQCM","code_information":[{"code":"14021","type":"CPT"}],"standard_charges":[{"minimum":739.46,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1528.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":739.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":739.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":739.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1403","type":"APR-DRG"}],"standard_charges":[{"minimum":5063,"maximum":5063,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5063,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5063,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5063,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1404","type":"APR-DRG"}],"standard_charges":[{"minimum":8008,"maximum":8008,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8008,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8008,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8008,"methodology":"case rate"}]}]},{"description":"TIS TRNFR F/C/C/M/N/A/G/H/F","code_information":[{"code":"14040","type":"CPT"}],"standard_charges":[{"minimum":650.77,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1345.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":650.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":650.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":650.77,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"TIS TRNFR F/C/C/M/N/A/G/H/F","code_information":[{"code":"14041","type":"CPT"}],"standard_charges":[{"minimum":794.99,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1644.02,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.99,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"TIS TRNFR E/N/E/L 10 SQ CM/<","code_information":[{"code":"14060","type":"CPT"}],"standard_charges":[{"minimum":694.4,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1435.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":694.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":694.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":694.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"TIS TRNFR E/N/E/L10.1-30SQCM","code_information":[{"code":"14061","type":"CPT"}],"standard_charges":[{"minimum":853.39,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1764.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":853.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":853.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":853.39,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"MAJOR HEAD AND NECK PROCEDURES WITH CC","code_information":[{"code":"141","type":"MS-DRG"}],"standard_charges":[{"minimum":26746.72,"maximum":47406.35,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":35661.17,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":26746.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":26746.72,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29411.92,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":29411.92,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":30221.96,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":35888,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":29629,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":40783,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":46025.58,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":46485.84,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":47406.35,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":46946.1,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":46025.58,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":46025.58,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":46025.58,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":46485.84,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":46025.58,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1411","type":"APR-DRG"}],"standard_charges":[{"minimum":2606,"maximum":2606,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2606,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2606,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2606,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1412","type":"APR-DRG"}],"standard_charges":[{"minimum":3789,"maximum":3789,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3789,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3789,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3789,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1413","type":"APR-DRG"}],"standard_charges":[{"minimum":4556,"maximum":4556,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4556,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4556,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4556,"methodology":"case rate"}]}]},{"description":"ASTHMA","code_information":[{"code":"1414","type":"APR-DRG"}],"standard_charges":[{"minimum":8571,"maximum":8571,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8571,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8571,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8571,"methodology":"case rate"}]}]},{"description":"MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"142","type":"MS-DRG"}],"standard_charges":[{"minimum":19460.64,"maximum":43437.27,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25946.71,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19460.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19460.64,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21934.37,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21934.37,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22538.46,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26764,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22097,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":30415,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42172.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42593.83,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43437.27,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43015.55,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42172.1,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42172.1,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42172.1,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42593.83,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42172.1,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1421","type":"APR-DRG"}],"standard_charges":[{"minimum":3836,"maximum":3836,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3836,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3836,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3836,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1422","type":"APR-DRG"}],"standard_charges":[{"minimum":4964,"maximum":4964,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4964,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4964,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4964,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1423","type":"APR-DRG"}],"standard_charges":[{"minimum":6807,"maximum":6807,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6807,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6807,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6807,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1424","type":"APR-DRG"}],"standard_charges":[{"minimum":10494,"maximum":10494,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10494,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10494,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10494,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC","code_information":[{"code":"143","type":"MS-DRG"}],"standard_charges":[{"minimum":35418.23,"maximum":65468,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47222.82,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":35418.23,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":35418.23,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47213.54,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":47213.54,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":48513.85,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57609,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":47563,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":65468,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":55199.46,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":55751.46,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":56855.45,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":56303.45,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":55199.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":55199.46,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":55199.46,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":55751.46,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":55199.46,"methodology":"case rate"}]}]},{"description":"TIS TRNFR ANY 30.1-60 SQ CM","code_information":[{"code":"14301","type":"CPT"}],"standard_charges":[{"minimum":906.75,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1874.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"TIS TRNFR ADDL 30 SQ CM","code_information":[{"code":"14302","type":"CPT"}],"standard_charges":[{"minimum":224.62,"maximum":1867.98,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1867.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1867.98,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1867.98,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":464.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.62,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.62,"methodology":"fee schedule"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1431","type":"APR-DRG"}],"standard_charges":[{"minimum":3128,"maximum":3128,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3128,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3128,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1432","type":"APR-DRG"}],"standard_charges":[{"minimum":4547,"maximum":4547,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4547,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4547,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4547,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1433","type":"APR-DRG"}],"standard_charges":[{"minimum":6558,"maximum":6558,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6558,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6558,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6558,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1434","type":"APR-DRG"}],"standard_charges":[{"minimum":10193,"maximum":10193,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10193,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10193,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10193,"methodology":"case rate"}]}]},{"description":"FILLETED FINGER/TOE FLAP","code_information":[{"code":"14350","type":"CPT"}],"standard_charges":[{"minimum":708.46,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1464.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":708.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":708.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":708.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC","code_information":[{"code":"144","type":"MS-DRG"}],"standard_charges":[{"minimum":20972.89,"maximum":44835.15,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27962.98,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":20972.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":20972.89,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24567.91,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24567.91,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":25244.53,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29977,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":24750,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":34067,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43529.27,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":43964.57,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":44835.15,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44399.86,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43529.27,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43529.27,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43529.27,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":43964.57,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43529.27,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1441","type":"APR-DRG"}],"standard_charges":[{"minimum":3407,"maximum":3407,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3407,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3407,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3407,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1442","type":"APR-DRG"}],"standard_charges":[{"minimum":4339,"maximum":4339,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4339,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4339,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4339,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1443","type":"APR-DRG"}],"standard_charges":[{"minimum":6081,"maximum":6081,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6081,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6081,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6081,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1444","type":"APR-DRG"}],"standard_charges":[{"minimum":10382,"maximum":10382,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10382,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10382,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10382,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"145","type":"MS-DRG"}],"standard_charges":[{"minimum":14572.15,"maximum":40996.44,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19428.93,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14572.15,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14572.15,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17335.96,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":17335.96,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17813.41,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21153,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17464,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":24039,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39802.36,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40200.39,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40996.44,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40598.41,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39802.36,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39802.36,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39802.36,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40200.39,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39802.36,"methodology":"case rate"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1451","type":"APR-DRG"}],"standard_charges":[{"minimum":3119,"maximum":3119,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3119,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3119,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3119,"methodology":"case rate"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1452","type":"APR-DRG"}],"standard_charges":[{"minimum":3735,"maximum":3735,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3735,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3735,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3735,"methodology":"case rate"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1453","type":"APR-DRG"}],"standard_charges":[{"minimum":4971,"maximum":4971,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4971,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4971,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4971,"methodology":"case rate"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1454","type":"APR-DRG"}],"standard_charges":[{"minimum":8526,"maximum":8526,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8526,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8526,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8526,"methodology":"case rate"}]}]},{"description":"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC","code_information":[{"code":"146","type":"MS-DRG"}],"standard_charges":[{"minimum":21389.24,"maximum":47702.51,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28518.09,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":21389.24,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":21389.24,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29969.87,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":29969.87,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":30795.27,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36569,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":30192,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":41557,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":46313.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":46776.25,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":47702.51,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":47239.38,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":46313.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":46313.11,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":46313.11,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":46776.25,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":46313.11,"methodology":"case rate"}]}]},{"description":"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC","code_information":[{"code":"147","type":"MS-DRG"}],"standard_charges":[{"minimum":14691.79,"maximum":41107.21,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19588.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14691.79,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14691.79,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17544.65,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":17544.65,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":18027.85,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21408,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17674,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":24328,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39909.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40309.01,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41107.21,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40708.11,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39909.91,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39909.91,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39909.91,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40309.01,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39909.91,"methodology":"case rate"}]}]},{"description":"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC","code_information":[{"code":"148","type":"MS-DRG"}],"standard_charges":[{"minimum":12145.85,"maximum":38499.09,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16193.96,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12145.85,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12145.85,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12631.07,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12631.07,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12978.94,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15412,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":12724,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":17515,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37377.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37751.53,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38499.09,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38125.31,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37377.75,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37377.75,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37377.75,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37751.53,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37377.75,"methodology":"case rate"}]}]},{"description":"DYSEQUILIBRIUM","code_information":[{"code":"149","type":"MS-DRG"}],"standard_charges":[{"minimum":9071.1,"maximum":37406.4,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12094.43,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9071.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9071.1,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10572.51,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10572.51,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10863.68,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14353,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":16438,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":10651,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36316.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36680.06,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37406.4,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37043.23,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36316.89,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36316.89,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36316.89,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36680.06,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36316.89,"methodology":"case rate"}]}]},{"description":"EPISTAXIS WITH MCC","code_information":[{"code":"150","type":"MS-DRG"}],"standard_charges":[{"minimum":12428.2,"maximum":41700.28,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16570.42,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12428.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12428.2,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18661.96,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18661.96,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19175.93,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22771,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":18800,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":25877,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40485.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40890.56,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41700.28,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41295.42,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40485.7,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40485.7,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40485.7,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40890.56,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40485.7,"methodology":"case rate"}]}]},{"description":"WOUND PREP TRK/ARM/LEG","code_information":[{"code":"15002","type":"CPT"}],"standard_charges":[{"minimum":227.86,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":471.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":227.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":227.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":227.86,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"WOUND PREP ADDL 100 CM","code_information":[{"code":"15003","type":"CPT"}],"standard_charges":[{"minimum":46.87,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":96.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"}]}]},{"description":"WOUND PREP F/N/HF/G","code_information":[{"code":"15004","type":"CPT"}],"standard_charges":[{"minimum":271.49,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":561,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":271.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":271.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":271.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"WND PREP F/N/HF/G ADDL CM","code_information":[{"code":"15005","type":"CPT"}],"standard_charges":[{"minimum":93.02,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":192.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.02,"methodology":"fee schedule"}]}]},{"description":"HARVEST CULTURED SKIN GRAFT","code_information":[{"code":"15040","type":"CPT"}],"standard_charges":[{"minimum":129.07,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":266.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN PINCH GRAFT","code_information":[{"code":"15050","type":"CPT"}],"standard_charges":[{"minimum":483.48,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":999.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":483.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":483.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":483.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"EPISTAXIS WITHOUT MCC","code_information":[{"code":"151","type":"MS-DRG"}],"standard_charges":[{"minimum":7802.92,"maximum":37602.33,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10403.57,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7802.92,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7802.92,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10941.63,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10941.63,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11242.97,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13351,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":11023,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":15172,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36507.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36872.19,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37602.33,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37237.26,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36507.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36507.11,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36507.11,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36872.19,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36507.11,"methodology":"case rate"}]}]},{"description":"SKIN SPLT GRFT TRNK/ARM/LEG","code_information":[{"code":"15100","type":"CPT"}],"standard_charges":[{"minimum":748.12,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1546.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":748.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":748.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":748.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN SPLT GRFT T/A/L ADD-ON","code_information":[{"code":"15101","type":"CPT"}],"standard_charges":[{"minimum":115.01,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":238.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.01,"methodology":"fee schedule"}]}]},{"description":"EPIDRM AUTOGRFT TRNK/ARM/LEG","code_information":[{"code":"15110","type":"CPT"}],"standard_charges":[{"minimum":745.95,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1542.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":745.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":745.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":745.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"EPIDRM AUTOGRFT T/A/L ADD-ON","code_information":[{"code":"15111","type":"CPT"}],"standard_charges":[{"minimum":106,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":219.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":106,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":106,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":106,"methodology":"fee schedule"}]}]},{"description":"EPIDRM A-GRFT FACE/NCK/HF/G","code_information":[{"code":"15115","type":"CPT"}],"standard_charges":[{"minimum":721.44,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1492.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":721.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":721.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":721.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"EPIDRM A-GRFT F/N/HF/G ADDL","code_information":[{"code":"15116","type":"CPT"}],"standard_charges":[{"minimum":144.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":299.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":144.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":144.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":144.94,"methodology":"fee schedule"}]}]},{"description":"SKN SPLT A-GRFT FAC/NCK/HF/G","code_information":[{"code":"15120","type":"CPT"}],"standard_charges":[{"minimum":721.08,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1490.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":721.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":721.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":721.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"SKN SPLT A-GRFT F/N/HF/G ADD","code_information":[{"code":"15121","type":"CPT"}],"standard_charges":[{"minimum":138.81,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":287.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":138.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":138.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":138.81,"methodology":"fee schedule"}]}]},{"description":"DERM AUTOGRAFT TRNK/ARM/LEG","code_information":[{"code":"15130","type":"CPT"}],"standard_charges":[{"minimum":624.09,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1290.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":624.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":624.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":624.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"DERM AUTOGRAFT T/A/L ADD-ON","code_information":[{"code":"15131","type":"CPT"}],"standard_charges":[{"minimum":93.38,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":192.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"}]}]},{"description":"DERM AUTOGRAFT FACE/NCK/HF/G","code_information":[{"code":"15135","type":"CPT"}],"standard_charges":[{"minimum":794.99,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1643.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.99,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"DERM AUTOGRAFT F/N/HF/G ADD","code_information":[{"code":"15136","type":"CPT"}],"standard_charges":[{"minimum":93.38,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":192.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"}]}]},{"description":"CULT SKIN GRFT T/ARM/LEG","code_information":[{"code":"15150","type":"CPT"}],"standard_charges":[{"minimum":667.36,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1380.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":667.36,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":667.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":667.36,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"CULT SKIN GRFT T/A/L ADDL","code_information":[{"code":"15151","type":"CPT"}],"standard_charges":[{"minimum":113.57,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":234.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.57,"methodology":"fee schedule"}]}]},{"description":"CULT SKIN GRAFT T/A/L +%","code_information":[{"code":"15152","type":"CPT"}],"standard_charges":[{"minimum":146.74,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":303.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.74,"methodology":"fee schedule"}]}]},{"description":"CULT SKIN GRAFT F/N/HF/G","code_information":[{"code":"15155","type":"CPT"}],"standard_charges":[{"minimum":763.26,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1578.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"CULT SKIN GRFT F/N/HFG ADD","code_information":[{"code":"15156","type":"CPT"}],"standard_charges":[{"minimum":155.39,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":321.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":155.39,"methodology":"fee schedule"}]}]},{"description":"CULT EPIDERM GRFT F/N/HFG +%","code_information":[{"code":"15157","type":"CPT"}],"standard_charges":[{"minimum":169.81,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":351.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.81,"methodology":"fee schedule"}]}]},{"description":"OTITIS MEDIA AND URI WITH MCC","code_information":[{"code":"152","type":"MS-DRG"}],"standard_charges":[{"minimum":7661.75,"maximum":40748.51,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10215.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7661.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7661.75,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16868.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":16868.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17333.46,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20583,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":16994,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":23391,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39561.66,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39957.28,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40748.51,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40352.9,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39561.66,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39561.66,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39561.66,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39957.28,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39561.66,"methodology":"case rate"}]}]},{"description":"SKIN FULL GRAFT TRUNK","code_information":[{"code":"15200","type":"CPT"}],"standard_charges":[{"minimum":701.61,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1451.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":701.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":701.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":701.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN FULL GRAFT TRUNK ADD-ON","code_information":[{"code":"15201","type":"CPT"}],"standard_charges":[{"minimum":79.68,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":164.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"}]}]},{"description":"SKIN FULL GRAFT SCLP/ARM/LEG","code_information":[{"code":"15220","type":"CPT"}],"standard_charges":[{"minimum":636.35,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1315.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":636.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":636.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":636.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN FULL GRAFT ADD-ON","code_information":[{"code":"15221","type":"CPT"}],"standard_charges":[{"minimum":71.75,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":148.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.75,"methodology":"fee schedule"}]}]},{"description":"SKIN FULL GRFT FACE/GENIT/HF","code_information":[{"code":"15240","type":"CPT"}],"standard_charges":[{"minimum":829.6,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1715.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":829.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":829.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":829.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN FULL GRAFT ADD-ON","code_information":[{"code":"15241","type":"CPT"}],"standard_charges":[{"minimum":109.6,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":226.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.6,"methodology":"fee schedule"}]}]},{"description":"SKIN FULL GRAFT EEN  LIPS","code_information":[{"code":"15260","type":"CPT"}],"standard_charges":[{"minimum":882.24,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1824.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":882.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":882.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":882.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN FULL GRAFT ADD-ON","code_information":[{"code":"15261","type":"CPT"}],"standard_charges":[{"minimum":141.33,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":292.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":141.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":141.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":141.33,"methodology":"fee schedule"}]}]},{"description":"SKIN SUB GRAFT TRNK/ARM/LEG","code_information":[{"code":"15271","type":"CPT"}],"standard_charges":[{"minimum":86.89,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":179.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN SUB GRAFT T/A/L ADD-ON","code_information":[{"code":"15272","type":"CPT"}],"standard_charges":[{"minimum":17.31,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":35.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.31,"methodology":"fee schedule"}]}]},{"description":"SKIN SUB GRFT T/ARM/LG CHILD","code_information":[{"code":"15273","type":"CPT"}],"standard_charges":[{"minimum":203.34,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":420.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.34,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.34,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"SKN SUB GRFT T/A/L CHILD ADD","code_information":[{"code":"15274","type":"CPT"}],"standard_charges":[{"minimum":46.51,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":96.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.51,"methodology":"fee schedule"}]}]},{"description":"SKIN SUB GRAFT FACE/NK/HF/G","code_information":[{"code":"15275","type":"CPT"}],"standard_charges":[{"minimum":97.35,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":200.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN SUB GRAFT F/N/HF/G ADDL","code_information":[{"code":"15276","type":"CPT"}],"standard_charges":[{"minimum":25.96,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":53.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.96,"methodology":"fee schedule"}]}]},{"description":"SKN SUB GRFT F/N/HF/G CHILD","code_information":[{"code":"15277","type":"CPT"}],"standard_charges":[{"minimum":233.27,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":482.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":233.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":233.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":233.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKN SUB GRFT F/N/HF/G CH ADD","code_information":[{"code":"15278","type":"CPT"}],"standard_charges":[{"minimum":58.05,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":119.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.05,"methodology":"fee schedule"}]}]},{"description":"OTITIS MEDIA AND URI WITHOUT MCC","code_information":[{"code":"153","type":"MS-DRG"}],"standard_charges":[{"minimum":5828.86,"maximum":37331.8,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7771.57,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5828.86,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5828.86,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10431.96,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10431.96,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10719.26,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12729,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":10509,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14465,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36244.46,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36606.91,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37331.8,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36969.35,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36244.46,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36244.46,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36244.46,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36606.91,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36244.46,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC","code_information":[{"code":"154","type":"MS-DRG"}],"standard_charges":[{"minimum":14407.05,"maximum":43386.03,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19208.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14407.05,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14407.05,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21837.83,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":21837.83,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22439.26,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26646,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":21999,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":30281,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42122.35,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42543.58,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43386.03,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":42964.8,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42122.35,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42122.35,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42122.35,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42543.58,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42122.35,"methodology":"case rate"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC","code_information":[{"code":"155","type":"MS-DRG"}],"standard_charges":[{"minimum":11006.88,"maximum":38927.87,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14675.38,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11006.88,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11006.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13438.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":13438.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13809,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16398,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":13538,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":18635,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37794.04,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38171.99,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38927.87,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38549.93,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37794.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37794.04,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37794.04,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38171.99,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37794.04,"methodology":"case rate"}]}]},{"description":"SKIN PEDICLE FLAP TRUNK","code_information":[{"code":"15570","type":"CPT"}],"standard_charges":[{"minimum":763.98,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1579.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN PEDICLE FLAP ARMS/LEGS","code_information":[{"code":"15572","type":"CPT"}],"standard_charges":[{"minimum":770.11,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1592.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":770.11,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":770.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":770.11,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"PEDCLE FH/CH/CH/M/N/AX/G/H/F","code_information":[{"code":"15574","type":"CPT"}],"standard_charges":[{"minimum":769.03,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1590.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":769.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":769.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":769.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"PEDICLE E/N/E/L/NTRORAL","code_information":[{"code":"15576","type":"CPT"}],"standard_charges":[{"minimum":678.17,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1402.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":678.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":678.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":678.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC","code_information":[{"code":"156","type":"MS-DRG"}],"standard_charges":[{"minimum":9306.13,"maximum":36734.21,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12604.88,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9453.95,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9453.95,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9306.13,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9306.13,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":9562.43,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11355,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":9375,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":12904,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":35664.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36020.93,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":36734.21,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36377.57,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":35664.28,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":35664.28,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":35664.28,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36020.93,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":35664.28,"methodology":"case rate"}]}]},{"description":"DELAY FLAP TRUNK","code_information":[{"code":"15600","type":"CPT"}],"standard_charges":[{"minimum":221.37,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":457.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":221.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":221.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":221.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"DELAY FLAP ARMS/LEGS","code_information":[{"code":"15610","type":"CPT"}],"standard_charges":[{"minimum":255.98,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":529.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":255.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":255.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":255.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"DELAY FLAP F/C/C/N/AX/G/H/F","code_information":[{"code":"15620","type":"CPT"}],"standard_charges":[{"minimum":341.79,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":707.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":341.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":341.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":341.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"DELAY FLAP EYE/NOS/EAR/LIP","code_information":[{"code":"15630","type":"CPT"}],"standard_charges":[{"minimum":359.46,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":743.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"TRANSFER SKIN PEDICLE FLAP","code_information":[{"code":"15650","type":"CPT"}],"standard_charges":[{"minimum":422.19,"maximum":4367,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":872.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":422.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":422.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":422.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"DENTAL AND ORAL DISEASES WITH MCC","code_information":[{"code":"157","type":"MS-DRG"}],"standard_charges":[{"minimum":16720.89,"maximum":44658.07,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22293.82,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16720.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16720.89,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24234.28,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24234.28,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":24901.72,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29570,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":24414,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":33604,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43357.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":43790.92,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":44658.07,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44224.49,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43357.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43357.34,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43357.34,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":43790.92,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43357.34,"methodology":"case rate"}]}]},{"description":"MDFC FLAP W/PRSRV VASC PEDCL","code_information":[{"code":"15730","type":"CPT"}],"standard_charges":[{"minimum":956.51,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1977.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":956.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":956.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":956.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"FOREHEAD FLAP W/VASC PEDICLE","code_information":[{"code":"15731","type":"CPT"}],"standard_charges":[{"minimum":1044.48,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2159.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1044.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1044.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1044.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"MUSC MYOQ/FSCQ FLP HN PEDCL","code_information":[{"code":"15733","type":"CPT"}],"standard_charges":[{"minimum":1078.37,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2230.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1078.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1078.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1078.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"MUSCLE-SKIN GRAFT TRUNK","code_information":[{"code":"15734","type":"CPT"}],"standard_charges":[{"minimum":1566.54,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3239.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1566.54,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1566.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1566.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"MUSCLE-SKIN GRAFT ARM","code_information":[{"code":"15736","type":"CPT"}],"standard_charges":[{"minimum":1270.9,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2627.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1270.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1270.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1270.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"MUSCLE-SKIN GRAFT LEG","code_information":[{"code":"15738","type":"CPT"}],"standard_charges":[{"minimum":1326.42,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2742.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1326.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1326.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1326.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"ISLAND PEDICLE FLAP GRAFT","code_information":[{"code":"15740","type":"CPT"}],"standard_charges":[{"minimum":879.35,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1818.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":879.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":879.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":879.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"NEUROVASCULAR PEDICLE FLAP","code_information":[{"code":"15750","type":"CPT"}],"standard_charges":[{"minimum":967.32,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2000.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":967.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":967.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":967.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"FREE MYO/SKIN FLAP MICROVASC","code_information":[{"code":"15756","type":"CPT"}],"standard_charges":[{"minimum":2392.89,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4948.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2392.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2392.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2392.89,"methodology":"fee schedule"}]}]},{"description":"FREE SKIN FLAP MICROVASC","code_information":[{"code":"15757","type":"CPT"}],"standard_charges":[{"minimum":2379.91,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4920.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2379.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2379.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2379.91,"methodology":"fee schedule"}]}]},{"description":"FREE FASCIAL FLAP MICROVASC","code_information":[{"code":"15758","type":"CPT"}],"standard_charges":[{"minimum":2371.26,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4903.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2371.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2371.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2371.26,"methodology":"fee schedule"}]}]},{"description":"COMPOSITE SKIN GRAFT","code_information":[{"code":"15760","type":"CPT"}],"standard_charges":[{"minimum":732.61,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1514.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":732.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":732.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":732.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"GRFG AUTOL SOFT TISS DIR EXC","code_information":[{"code":"15769","type":"CPT"}],"standard_charges":[{"minimum":503.67,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1041.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":503.67,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":503.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":503.67,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"DERMA-FAT-FASCIA GRAFT","code_information":[{"code":"15770","type":"CPT"}],"standard_charges":[{"minimum":704.49,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1456.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"GRFG AUTOL FAT LIPO 50 CC/<","code_information":[{"code":"15771","type":"CPT"}],"standard_charges":[{"minimum":531.79,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1099.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"GRFG AUTOL FAT LIPO EA ADDL","code_information":[{"code":"15772","type":"CPT"}],"standard_charges":[{"minimum":154.31,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":319.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":154.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":154.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":154.31,"methodology":"fee schedule"}]}]},{"description":"GRFG AUTOL FAT LIPO 25 CC/<","code_information":[{"code":"15773","type":"CPT"}],"standard_charges":[{"minimum":524.94,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1085.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"GFRG AUTOL FAT LIPO EA ADDL","code_information":[{"code":"15774","type":"CPT"}],"standard_charges":[{"minimum":149.98,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1321.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":310.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.98,"methodology":"fee schedule"}]}]},{"description":"HAIR TRNSPL 1-15 PUNCH GRFTS","code_information":[{"code":"15775","type":"CPT"}],"standard_charges":[{"minimum":381.96,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":550,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"HAIR TRNSPL >15 PUNCH GRAFTS","code_information":[{"code":"15776","type":"CPT"}],"standard_charges":[{"minimum":381.96,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":751.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"ACELLULAR DERM MATRIX IMPLT","code_information":[{"code":"15777","type":"CPT"}],"standard_charges":[{"minimum":223.17,"maximum":2945.22,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":461.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.17,"methodology":"fee schedule"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"15778","type":"CPT"}],"standard_charges":[{"minimum":828.21,"maximum":2945.22,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2945.22,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":828.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"DERMABRASION TOTAL FACE","code_information":[{"code":"15780","type":"CPT"}],"standard_charges":[{"minimum":1431.89,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1431.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"DERMABRASION SEGMENTAL FACE","code_information":[{"code":"15781","type":"CPT"}],"standard_charges":[{"minimum":664.43,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":927.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"DERMABRASION OTHER THAN FACE","code_information":[{"code":"15782","type":"CPT"}],"standard_charges":[{"minimum":796.99,"maximum":2724.13,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":796.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"DERMABRASION SUPRFL ANY SITE","code_information":[{"code":"15783","type":"CPT"}],"standard_charges":[{"minimum":381.96,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":765.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"ABRASION LESION SINGLE","code_information":[{"code":"15786","type":"CPT"}],"standard_charges":[{"minimum":184.88,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":291.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"ABRASION LESIONS ADD-ON","code_information":[{"code":"15787","type":"CPT"}],"standard_charges":[{"minimum":35.93,"maximum":103.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":103.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":103.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":35.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CHEMICAL PEEL FACE EPIDERM","code_information":[{"code":"15788","type":"CPT"}],"standard_charges":[{"minimum":224.98,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":465.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"CHEMICAL PEEL FACE DERMAL","code_information":[{"code":"15789","type":"CPT"}],"standard_charges":[{"minimum":427.6,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":884.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":427.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":427.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":427.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CHEMICAL PEEL NONFACIAL","code_information":[{"code":"15792","type":"CPT"}],"standard_charges":[{"minimum":218.13,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":451.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"CHEMICAL PEEL NONFACIAL","code_information":[{"code":"15793","type":"CPT"}],"standard_charges":[{"minimum":370.27,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":765.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DENTAL AND ORAL DISEASES WITH CC","code_information":[{"code":"158","type":"MS-DRG"}],"standard_charges":[{"minimum":12148.25,"maximum":38866.83,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16197.15,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12148.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12148.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13323.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":13323.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13690.84,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16258,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":13422,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":18475,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37734.78,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38112.13,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38866.83,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38489.48,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37734.78,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37734.78,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37734.78,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38112.13,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37734.78,"methodology":"case rate"}]}]},{"description":"PLASTIC SURGERY NECK","code_information":[{"code":"15819","type":"CPT"}],"standard_charges":[{"minimum":1732.57,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1732.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REVISION OF LOWER EYELID","code_information":[{"code":"15820","type":"CPT"}],"standard_charges":[{"minimum":1111.24,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1111.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REVISION OF LOWER EYELID","code_information":[{"code":"15821","type":"CPT"}],"standard_charges":[{"minimum":1186.66,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1186.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REVISION OF UPPER EYELID","code_information":[{"code":"15822","type":"CPT"}],"standard_charges":[{"minimum":862.27,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":862.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REVISION OF UPPER EYELID","code_information":[{"code":"15823","type":"CPT"}],"standard_charges":[{"minimum":574.7,"maximum":4367,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1188.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":574.7,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":574.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":574.7,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF FOREHEAD WRINKLES","code_information":[{"code":"15824","type":"CPT"}],"standard_charges":[{"minimum":1766.97,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2426.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF NECK WRINKLES","code_information":[{"code":"15825","type":"CPT"}],"standard_charges":[{"minimum":2525,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2729.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF BROW WRINKLES","code_information":[{"code":"15826","type":"CPT"}],"standard_charges":[{"minimum":1970.98,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1970.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF FACE WRINKLES","code_information":[{"code":"15828","type":"CPT"}],"standard_charges":[{"minimum":2525,"maximum":5154.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5154.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF SKIN WRINKLES","code_information":[{"code":"15829","type":"CPT"}],"standard_charges":[{"minimum":2661,"maximum":5761.73,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5761.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"EXC SKIN ABD","code_information":[{"code":"15830","type":"CPT"}],"standard_charges":[{"minimum":1226.19,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2535.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1226.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1226.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1226.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESSIVE SKIN THIGH","code_information":[{"code":"15832","type":"CPT"}],"standard_charges":[{"minimum":1997.47,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1997.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESSIVE SKIN LEG","code_information":[{"code":"15833","type":"CPT"}],"standard_charges":[{"minimum":1900.89,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1900.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESSIVE SKIN HIP","code_information":[{"code":"15834","type":"CPT"}],"standard_charges":[{"minimum":1934.97,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1934.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESSIVE SKIN BUTTCK","code_information":[{"code":"15835","type":"CPT"}],"standard_charges":[{"minimum":2017.07,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2017.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESSIVE SKIN ARM","code_information":[{"code":"15836","type":"CPT"}],"standard_charges":[{"minimum":1727.51,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1727.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESS SKIN ARM/HAND","code_information":[{"code":"15837","type":"CPT"}],"standard_charges":[{"minimum":1553.18,"maximum":4244.02,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1553.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESS SKIN FAT PAD","code_information":[{"code":"15838","type":"CPT"}],"standard_charges":[{"minimum":1408.51,"maximum":4244.02,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1408.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISE EXCESS SKIN  TISSUE","code_information":[{"code":"15839","type":"CPT"}],"standard_charges":[{"minimum":1603.73,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1603.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"NERVE PALSY FASCIAL GRAFT","code_information":[{"code":"15840","type":"CPT"}],"standard_charges":[{"minimum":1062.51,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2196.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"NERVE PALSY MUSCLE GRAFT","code_information":[{"code":"15841","type":"CPT"}],"standard_charges":[{"minimum":1860.74,"maximum":3847.76,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3847.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1860.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1860.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1860.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"NERVE PALSY MICROSURG GRAFT","code_information":[{"code":"15842","type":"CPT"}],"standard_charges":[{"minimum":1766.97,"maximum":5828.68,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5828.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2818.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2818.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2818.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SKIN AND MUSCLE REPAIR FACE","code_information":[{"code":"15845","type":"CPT"}],"standard_charges":[{"minimum":1111.18,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2297.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.18,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"EXC SKIN ABD ADD-ON","code_information":[{"code":"15847","type":"CPT"}],"standard_charges":[{"minimum":378.49,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":800.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":378.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":378.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":378.49,"methodology":"fee schedule"}]}]},{"description":"REMOVE SUTURES SAME SURGEON","code_information":[{"code":"15850","type":"CPT"}],"standard_charges":[{"minimum":85.67,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":85.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REMOVE SUTURES DIFF SURGEON","code_information":[{"code":"15851","type":"CPT"}],"standard_charges":[{"minimum":68.14,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":140.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"DRESSING CHANGE NOT FOR BURN","code_information":[{"code":"15852","type":"CPT"}],"standard_charges":[{"minimum":47.95,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":99.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"15853","type":"CPT"}],"standard_charges":[{"minimum":24.33,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":24.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"15854","type":"CPT"}],"standard_charges":[{"minimum":34.3,"maximum":985.56,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":34.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"TEST FOR BLOOD FLOW IN GRAFT","code_information":[{"code":"15860","type":"CPT"}],"standard_charges":[{"minimum":111.05,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":503.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":503.29,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":503.29,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":229.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":398.16,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":394.3,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"}]}]},{"description":"SUCTION LIPECTOMY HEADNECK","code_information":[{"code":"15876","type":"CPT"}],"standard_charges":[{"minimum":2525,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"SUCTION LIPECTOMY TRUNK","code_information":[{"code":"15877","type":"CPT"}],"standard_charges":[{"minimum":2525,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"SUCTION LIPECTOMY UPR EXTREM","code_information":[{"code":"15878","type":"CPT"}],"standard_charges":[{"minimum":1766.97,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SUCTION LIPECTOMY LWR EXTREM","code_information":[{"code":"15879","type":"CPT"}],"standard_charges":[{"minimum":2525,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"DENTAL AND ORAL DISEASES WITHOUT CC/MCC","code_information":[{"code":"159","type":"MS-DRG"}],"standard_charges":[{"minimum":9585.81,"maximum":36882.67,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13778.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10334.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10334.5,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9585.81,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9585.81,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":9849.82,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11696,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":9657,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13292,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":35808.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36166.5,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":36882.67,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36524.58,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":35808.41,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":35808.41,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":35808.41,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36166.5,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":35808.41,"methodology":"case rate"}]}]},{"description":"REMOVAL OF TAIL BONE ULCER","code_information":[{"code":"15920","type":"CPT"}],"standard_charges":[{"minimum":672.04,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1389.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":672.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":672.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":672.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF TAIL BONE ULCER","code_information":[{"code":"15922","type":"CPT"}],"standard_charges":[{"minimum":837.17,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1730.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":837.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":837.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":837.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVE SACRUM PRESSURE SORE","code_information":[{"code":"15931","type":"CPT"}],"standard_charges":[{"minimum":739.1,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1528.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":739.1,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":739.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":739.1,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE SACRUM PRESSURE SORE","code_information":[{"code":"15933","type":"CPT"}],"standard_charges":[{"minimum":912.88,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1887.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":912.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":912.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":912.88,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE SACRUM PRESSURE SORE","code_information":[{"code":"15934","type":"CPT"}],"standard_charges":[{"minimum":994,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2055.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":994,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":994,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":994,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVE SACRUM PRESSURE SORE","code_information":[{"code":"15935","type":"CPT"}],"standard_charges":[{"minimum":1211.77,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2505.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1211.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1211.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1211.77,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVE SACRUM PRESSURE SORE","code_information":[{"code":"15936","type":"CPT"}],"standard_charges":[{"minimum":944.61,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1953.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":944.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":944.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":944.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVE SACRUM PRESSURE SORE","code_information":[{"code":"15937","type":"CPT"}],"standard_charges":[{"minimum":1093.87,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2262.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1093.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1093.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1093.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVE HIP PRESSURE SORE","code_information":[{"code":"15940","type":"CPT"}],"standard_charges":[{"minimum":743.43,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1537.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":743.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":743.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":743.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE HIP PRESSURE SORE","code_information":[{"code":"15941","type":"CPT"}],"standard_charges":[{"minimum":982.11,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2031.02,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":982.11,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":982.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":982.11,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE HIP PRESSURE SORE","code_information":[{"code":"15944","type":"CPT"}],"standard_charges":[{"minimum":980.66,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2027.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":980.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":980.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":980.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVE HIP PRESSURE SORE","code_information":[{"code":"15945","type":"CPT"}],"standard_charges":[{"minimum":1069.72,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2211.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1069.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1069.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1069.72,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVE HIP PRESSURE SORE","code_information":[{"code":"15946","type":"CPT"}],"standard_charges":[{"minimum":1693.09,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3500.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1693.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1693.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1693.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVE THIGH PRESSURE SORE","code_information":[{"code":"15950","type":"CPT"}],"standard_charges":[{"minimum":668.44,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1382.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":668.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":668.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":668.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"REMOVE THIGH PRESSURE SORE","code_information":[{"code":"15951","type":"CPT"}],"standard_charges":[{"minimum":943.53,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1950.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":943.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":943.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":943.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE THIGH PRESSURE SORE","code_information":[{"code":"15952","type":"CPT"}],"standard_charges":[{"minimum":961.55,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1988.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":961.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":961.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":961.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVE THIGH PRESSURE SORE","code_information":[{"code":"15953","type":"CPT"}],"standard_charges":[{"minimum":1058.9,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2189.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1058.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1058.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1058.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVE THIGH PRESSURE SORE","code_information":[{"code":"15956","type":"CPT"}],"standard_charges":[{"minimum":1218.98,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2520.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1218.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1218.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1218.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVE THIGH PRESSURE SORE","code_information":[{"code":"15958","type":"CPT"}],"standard_charges":[{"minimum":1236.28,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2556.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1236.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1236.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1236.28,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF PRESSURE SORE","code_information":[{"code":"15999","type":"CPT"}],"standard_charges":[{"minimum":464.46,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":464.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":464.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":464.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"INITIAL TREATMENT OF BURN(S)","code_information":[{"code":"16000","type":"CPT"}],"standard_charges":[{"minimum":47.95,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":98.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1601","type":"APR-DRG"}],"standard_charges":[{"minimum":21347,"maximum":21347,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":21347,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":21347,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":21347,"methodology":"case rate"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1602","type":"APR-DRG"}],"standard_charges":[{"minimum":25166,"maximum":25166,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25166,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25166,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25166,"methodology":"case rate"}]}]},{"description":"DRESS/DEBRID P-THICK BURN S","code_information":[{"code":"16020","type":"CPT"}],"standard_charges":[{"minimum":57.69,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":119.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DRESS/DEBRID P-THICK BURN M","code_information":[{"code":"16025","type":"CPT"}],"standard_charges":[{"minimum":115.01,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":238.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1603","type":"APR-DRG"}],"standard_charges":[{"minimum":34134,"maximum":34134,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":34134,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":34134,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":34134,"methodology":"case rate"}]}]},{"description":"DRESS/DEBRID P-THICK BURN L","code_information":[{"code":"16030","type":"CPT"}],"standard_charges":[{"minimum":137,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":382.8,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":283.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":137,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":137,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":137,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"INCISION OF BURN SCAB INITI","code_information":[{"code":"16035","type":"CPT"}],"standard_charges":[{"minimum":202.98,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":419.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":202.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":202.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":202.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"ESCHAROTOMY ADDL INCISION","code_information":[{"code":"16036","type":"CPT"}],"standard_charges":[{"minimum":85.81,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":177.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1604","type":"APR-DRG"}],"standard_charges":[{"minimum":71957,"maximum":71957,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":71957,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":71957,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":71957,"methodology":"case rate"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1611","type":"APR-DRG"}],"standard_charges":[{"minimum":74345,"maximum":74345,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":74345,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":74345,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":74345,"methodology":"case rate"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1612","type":"APR-DRG"}],"standard_charges":[{"minimum":74345,"maximum":74345,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":74345,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":74345,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":74345,"methodology":"case rate"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1613","type":"APR-DRG"}],"standard_charges":[{"minimum":106148,"maximum":106148,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":106148,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":106148,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":106148,"methodology":"case rate"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1614","type":"APR-DRG"}],"standard_charges":[{"minimum":152253,"maximum":152253,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":152253,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":152253,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":152253,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1621","type":"APR-DRG"}],"standard_charges":[{"minimum":26259,"maximum":26259,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26259,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26259,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26259,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1622","type":"APR-DRG"}],"standard_charges":[{"minimum":30345,"maximum":30345,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":30345,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":30345,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":30345,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1623","type":"APR-DRG"}],"standard_charges":[{"minimum":40718,"maximum":40718,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40718,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40718,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40718,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1624","type":"APR-DRG"}],"standard_charges":[{"minimum":62781,"maximum":62781,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":62781,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":62781,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":62781,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST PROCEDURES WITH MCC","code_information":[{"code":"163","type":"MS-DRG"}],"standard_charges":[{"minimum":60781.91,"maximum":92792,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":81040,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":60781.91,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":60781.91,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":66918.98,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":66918.98,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":68762,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":81654,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":67414,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":92792,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":65354.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":66008,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":67315.09,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":66661.54,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":65354.45,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":65354.45,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":65354.45,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":66008,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":65354.45,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1631","type":"APR-DRG"}],"standard_charges":[{"minimum":22567,"maximum":22567,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":22567,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":22567,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":22567,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1632","type":"APR-DRG"}],"standard_charges":[{"minimum":24948,"maximum":24948,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24948,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24948,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24948,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1633","type":"APR-DRG"}],"standard_charges":[{"minimum":33261,"maximum":33261,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":33261,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":33261,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":33261,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1634","type":"APR-DRG"}],"standard_charges":[{"minimum":52225,"maximum":52225,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":52225,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":52225,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":52225,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST PROCEDURES WITH CC","code_information":[{"code":"164","type":"MS-DRG"}],"standard_charges":[{"minimum":36208.03,"maximum":56254.56,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56254.56,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":42192.24,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":42192.24,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36208.03,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":36208.03,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":37205.24,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44181,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":36476,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":50207,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":49527.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":50023.17,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":51013.73,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":50518.45,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":49527.89,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":49527.89,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":49527.89,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":50023.17,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":49527.89,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"165","type":"MS-DRG"}],"standard_charges":[{"minimum":26639.25,"maximum":48294.76,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48294.76,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":36222.21,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":36222.21,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26639.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":26639.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":27372.92,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32505,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":26836,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":36939,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44596.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":45042.69,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45934.63,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45488.66,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44596.72,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44596.72,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44596.72,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":45042.69,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44596.72,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1651","type":"APR-DRG"}],"standard_charges":[{"minimum":21953,"maximum":21953,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":21953,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":21953,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":21953,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1652","type":"APR-DRG"}],"standard_charges":[{"minimum":25927,"maximum":25927,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25927,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25927,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25927,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1653","type":"APR-DRG"}],"standard_charges":[{"minimum":32900,"maximum":32900,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":32900,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":32900,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":32900,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1654","type":"APR-DRG"}],"standard_charges":[{"minimum":48199,"maximum":48199,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":48199,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":48199,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":48199,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC","code_information":[{"code":"166","type":"MS-DRG"}],"standard_charges":[{"minimum":50562.26,"maximum":79882,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67414.23,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":50562.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":50562.26,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57608.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":57608.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":59195.19,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70293,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":58035,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":79882,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":60556.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":61162.01,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":62373.14,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":61767.57,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":60556.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":60556.44,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":60556.44,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":61162.01,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":60556.44,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1661","type":"APR-DRG"}],"standard_charges":[{"minimum":19293,"maximum":19293,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":19293,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":19293,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":19293,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1662","type":"APR-DRG"}],"standard_charges":[{"minimum":21531,"maximum":21531,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":21531,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":21531,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":21531,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1663","type":"APR-DRG"}],"standard_charges":[{"minimum":26996,"maximum":26996,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26996,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26996,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26996,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1664","type":"APR-DRG"}],"standard_charges":[{"minimum":41537,"maximum":41537,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":41537,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":41537,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":41537,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC","code_information":[{"code":"167","type":"MS-DRG"}],"standard_charges":[{"minimum":25835.7,"maximum":49826.11,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49826.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":37370.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":37370.75,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25835.7,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25835.7,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":26547.24,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31524,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":26027,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":35825,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44182.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44624.44,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45508.09,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45066.27,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44182.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44182.61,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44182.61,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44624.44,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44182.61,"methodology":"case rate"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1671","type":"APR-DRG"}],"standard_charges":[{"minimum":18628,"maximum":18628,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":18628,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":18628,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":18628,"methodology":"case rate"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1672","type":"APR-DRG"}],"standard_charges":[{"minimum":18628,"maximum":18628,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":18628,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":18628,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":18628,"methodology":"case rate"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1673","type":"APR-DRG"}],"standard_charges":[{"minimum":28997,"maximum":28997,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":28997,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":28997,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":28997,"methodology":"case rate"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1674","type":"APR-DRG"}],"standard_charges":[{"minimum":50543,"maximum":50543,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":50543,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":50543,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":50543,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC","code_information":[{"code":"168","type":"MS-DRG"}],"standard_charges":[{"minimum":19246.87,"maximum":42010.75,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37508.36,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":28132.15,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":28132.15,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19246.87,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":19246.87,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19776.95,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23485,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":19389,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":26688,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40787.13,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":41195.01,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42010.75,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41602.88,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40787.13,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40787.13,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40787.13,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":41195.01,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40787.13,"methodology":"case rate"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1691","type":"APR-DRG"}],"standard_charges":[{"minimum":16259,"maximum":16259,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16259,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16259,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16259,"methodology":"case rate"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1692","type":"APR-DRG"}],"standard_charges":[{"minimum":17171,"maximum":17171,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17171,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17171,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17171,"methodology":"case rate"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1693","type":"APR-DRG"}],"standard_charges":[{"minimum":23881,"maximum":23881,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":23881,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":23881,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":23881,"methodology":"case rate"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1694","type":"APR-DRG"}],"standard_charges":[{"minimum":40640,"maximum":40640,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40640,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40640,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40640,"methodology":"case rate"}]}]},{"description":"DESTRUCT PREMALG LESION","code_information":[{"code":"17000","type":"CPT"}],"standard_charges":[{"minimum":57.33,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":118.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCT PREMALG LES 2-14","code_information":[{"code":"17003","type":"CPT"}],"standard_charges":[{"minimum":2.16,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.16,"methodology":"fee schedule"}]}]},{"description":"DESTROY PREMAL LESIONS 15/>","code_information":[{"code":"17004","type":"CPT"}],"standard_charges":[{"minimum":103.47,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":214.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1701","type":"APR-DRG"}],"standard_charges":[{"minimum":12650,"maximum":12650,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12650,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12650,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12650,"methodology":"case rate"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1702","type":"APR-DRG"}],"standard_charges":[{"minimum":14918,"maximum":14918,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14918,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14918,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14918,"methodology":"case rate"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1703","type":"APR-DRG"}],"standard_charges":[{"minimum":17435,"maximum":17435,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17435,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17435,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17435,"methodology":"case rate"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1704","type":"APR-DRG"}],"standard_charges":[{"minimum":28735,"maximum":28735,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":28735,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":28735,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":28735,"methodology":"case rate"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17106","type":"CPT"}],"standard_charges":[{"minimum":288.43,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":596.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17107","type":"CPT"}],"standard_charges":[{"minimum":373.88,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":773.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.88,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17108","type":"CPT"}],"standard_charges":[{"minimum":548.74,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1134.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":548.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":548.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":548.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1711","type":"APR-DRG"}],"standard_charges":[{"minimum":9520,"maximum":9520,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9520,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9520,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9520,"methodology":"case rate"}]}]},{"description":"DESTRUCT B9 LESION 1-14","code_information":[{"code":"17110","type":"CPT"}],"standard_charges":[{"minimum":69.94,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":144.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCT LESION 15 OR MORE","code_information":[{"code":"17111","type":"CPT"}],"standard_charges":[{"minimum":85.81,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":177.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1712","type":"APR-DRG"}],"standard_charges":[{"minimum":10886,"maximum":10886,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10886,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10886,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10886,"methodology":"case rate"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1713","type":"APR-DRG"}],"standard_charges":[{"minimum":14323,"maximum":14323,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14323,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14323,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14323,"methodology":"case rate"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK","code_information":[{"code":"1714","type":"APR-DRG"}],"standard_charges":[{"minimum":23006,"maximum":23006,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":23006,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":23006,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":23006,"methodology":"case rate"}]}]},{"description":"CHEM CAUT OF GRANLTJ TISSUE","code_information":[{"code":"17250","type":"CPT"}],"standard_charges":[{"minimum":38.94,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":80.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17260","type":"CPT"}],"standard_charges":[{"minimum":73.91,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":152.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17261","type":"CPT"}],"standard_charges":[{"minimum":90.5,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":186.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.5,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.5,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17262","type":"CPT"}],"standard_charges":[{"minimum":115.37,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":238.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17263","type":"CPT"}],"standard_charges":[{"minimum":127.27,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":263.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17264","type":"CPT"}],"standard_charges":[{"minimum":135.92,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":281.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":135.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":135.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":135.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17266","type":"CPT"}],"standard_charges":[{"minimum":160.08,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":331.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17270","type":"CPT"}],"standard_charges":[{"minimum":99.87,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":206.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17271","type":"CPT"}],"standard_charges":[{"minimum":109.96,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":227.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.96,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17272","type":"CPT"}],"standard_charges":[{"minimum":126.19,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":261.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":126.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":126.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":126.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17273","type":"CPT"}],"standard_charges":[{"minimum":142.77,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":295.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.77,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17274","type":"CPT"}],"standard_charges":[{"minimum":174.86,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":361.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":174.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":174.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":174.86,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17276","type":"CPT"}],"standard_charges":[{"minimum":210.91,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":436.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":210.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":210.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":210.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17280","type":"CPT"}],"standard_charges":[{"minimum":90.13,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":186.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17281","type":"CPT"}],"standard_charges":[{"minimum":123.66,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":255.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17282","type":"CPT"}],"standard_charges":[{"minimum":142.41,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":294.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.41,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17283","type":"CPT"}],"standard_charges":[{"minimum":177.38,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":367.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":177.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":177.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":177.38,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":389.6,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":381.96,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17284","type":"CPT"}],"standard_charges":[{"minimum":207.31,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":428.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":207.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":207.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":207.31,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"DESTRUCTION OF SKIN LESIONS","code_information":[{"code":"17286","type":"CPT"}],"standard_charges":[{"minimum":280.14,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":579.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":280.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":280.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":280.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM","code_information":[{"code":"173","type":"MS-DRG"}],"standard_charges":[{"minimum":40998.24,"maximum":60534,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54662.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":40998.24,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":40998.24,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43655.78,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":43655.78,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":44858.1,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53268,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":43979,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":60534,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":53366,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":53899.66,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":54966.98,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":54433.32,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":53366,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":53366,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":53366,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":53899.66,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":53366,"methodology":"case rate"}]}]},{"description":"MOHS 1 STAGE H/N/HF/G","code_information":[{"code":"17311","type":"CPT"}],"standard_charges":[{"minimum":370.63,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":766.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"MOHS ADDL STAGE","code_information":[{"code":"17312","type":"CPT"}],"standard_charges":[{"minimum":197.57,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":408.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":197.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":197.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":197.57,"methodology":"fee schedule"}]}]},{"description":"MOHS 1 STAGE T/A/L","code_information":[{"code":"17313","type":"CPT"}],"standard_charges":[{"minimum":332.06,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":686.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":332.06,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":332.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":332.06,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"MOHS ADDL STAGE T/A/L","code_information":[{"code":"17314","type":"CPT"}],"standard_charges":[{"minimum":182.43,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":377.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.43,"methodology":"fee schedule"}]}]},{"description":"MOHS SURG ADDL BLOCK","code_information":[{"code":"17315","type":"CPT"}],"standard_charges":[{"minimum":52.64,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":108.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.64,"methodology":"fee schedule"}]}]},{"description":"CRYOTHERAPY OF SKIN","code_information":[{"code":"17340","type":"CPT"}],"standard_charges":[{"minimum":34.77,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":106.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":34.77,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":35.12,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":35.82,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":35.47,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":34.77,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":34.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":34.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":35.12,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":34.77,"methodology":"fee schedule"}]}]},{"description":"SKIN PEEL THERAPY","code_information":[{"code":"17360","type":"CPT"}],"standard_charges":[{"minimum":184.88,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":208.95,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":201.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"HAIR REMOVAL BY ELECTROLYSIS","code_information":[{"code":"17380","type":"CPT"}],"standard_charges":[{"minimum":169.86,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":169.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1741","type":"APR-DRG"}],"standard_charges":[{"minimum":11457,"maximum":11457,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11457,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11457,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11457,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1742","type":"APR-DRG"}],"standard_charges":[{"minimum":12693,"maximum":12693,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12693,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12693,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12693,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1743","type":"APR-DRG"}],"standard_charges":[{"minimum":16428,"maximum":16428,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16428,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16428,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16428,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1744","type":"APR-DRG"}],"standard_charges":[{"minimum":24121,"maximum":24121,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24121,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24121,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24121,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE","code_information":[{"code":"175","type":"MS-DRG"}],"standard_charges":[{"minimum":19918.39,"maximum":42367.19,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27066.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":20300.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":20300.52,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19918.39,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":19918.39,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":20466.96,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24304,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":20066,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":27619,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41133.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":41544.53,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42367.19,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41955.86,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41133.19,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41133.19,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41133.19,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":41544.53,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41133.19,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1751","type":"APR-DRG"}],"standard_charges":[{"minimum":12590,"maximum":12590,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12590,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12590,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12590,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1752","type":"APR-DRG"}],"standard_charges":[{"minimum":14246,"maximum":14246,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14246,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14246,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14246,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1753","type":"APR-DRG"}],"standard_charges":[{"minimum":17501,"maximum":17501,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17501,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17501,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17501,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1754","type":"APR-DRG"}],"standard_charges":[{"minimum":26742,"maximum":26742,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26742,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26742,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26742,"methodology":"case rate"}]}]},{"description":"PULMONARY EMBOLISM WITHOUT MCC","code_information":[{"code":"176","type":"MS-DRG"}],"standard_charges":[{"minimum":11579.07,"maximum":37940.68,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20982.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15737.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15737.45,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11579.07,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11579.07,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11897.97,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14129,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":11665,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":16056,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36835.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37203.97,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37940.68,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37572.33,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36835.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36835.61,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36835.61,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37203.97,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36835.61,"methodology":"case rate"}]}]},{"description":"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1761","type":"APR-DRG"}],"standard_charges":[{"minimum":10772,"maximum":10772,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10772,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10772,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10772,"methodology":"case rate"}]}]},{"description":"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1762","type":"APR-DRG"}],"standard_charges":[{"minimum":13207,"maximum":13207,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13207,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13207,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13207,"methodology":"case rate"}]}]},{"description":"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1763","type":"APR-DRG"}],"standard_charges":[{"minimum":20352,"maximum":20352,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":20352,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":20352,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":20352,"methodology":"case rate"}]}]},{"description":"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1764","type":"APR-DRG"}],"standard_charges":[{"minimum":34846,"maximum":34846,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":34846,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":34846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":34846,"methodology":"case rate"}]}]},{"description":"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC","code_information":[{"code":"177","type":"MS-DRG"}],"standard_charges":[{"minimum":24083.79,"maximum":44578.19,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37010.67,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":27758.87,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":27758.87,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24083.79,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24083.79,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":24747.08,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29387,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":24262,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":33395,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43279.79,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":43712.59,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":44578.19,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44145.39,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43279.79,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43279.79,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43279.79,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":43712.59,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43279.79,"methodology":"case rate"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1771","type":"APR-DRG"}],"standard_charges":[{"minimum":8026,"maximum":8026,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8026,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8026,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8026,"methodology":"case rate"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1772","type":"APR-DRG"}],"standard_charges":[{"minimum":11763,"maximum":11763,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11763,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11763,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11763,"methodology":"case rate"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1773","type":"APR-DRG"}],"standard_charges":[{"minimum":16095,"maximum":16095,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16095,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16095,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16095,"methodology":"case rate"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1774","type":"APR-DRG"}],"standard_charges":[{"minimum":21915,"maximum":21915,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":21915,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":21915,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":21915,"methodology":"case rate"}]}]},{"description":"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC","code_information":[{"code":"178","type":"MS-DRG"}],"standard_charges":[{"minimum":14008.18,"maximum":39230.06,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29398.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":22049.65,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":22049.65,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14008.18,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14008.18,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14393.98,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17093,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":14112,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":19424,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38087.43,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38468.31,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39230.06,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38849.18,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38087.43,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38087.43,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38087.43,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38468.31,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38087.43,"methodology":"case rate"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1781","type":"APR-DRG"}],"standard_charges":[{"minimum":28019,"maximum":28019,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":28019,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":28019,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":28019,"methodology":"case rate"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1782","type":"APR-DRG"}],"standard_charges":[{"minimum":31517,"maximum":31517,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":31517,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":31517,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":31517,"methodology":"case rate"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1783","type":"APR-DRG"}],"standard_charges":[{"minimum":36996,"maximum":36996,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":36996,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":36996,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":36996,"methodology":"case rate"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1784","type":"APR-DRG"}],"standard_charges":[{"minimum":52750,"maximum":52750,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":52750,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":52750,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":52750,"methodology":"case rate"}]}]},{"description":"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC","code_information":[{"code":"179","type":"MS-DRG"}],"standard_charges":[{"minimum":10836.57,"maximum":37546.56,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23968.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":17977.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":17977.11,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10836.57,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10836.57,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11135.02,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13223,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":10917,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":15026,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36452.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36817.5,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37546.56,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37182.03,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36452.97,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36452.97,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36452.97,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36817.5,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36452.97,"methodology":"case rate"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1791","type":"APR-DRG"}],"standard_charges":[{"minimum":22153,"maximum":22153,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":22153,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":22153,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":22153,"methodology":"case rate"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1792","type":"APR-DRG"}],"standard_charges":[{"minimum":25100,"maximum":25100,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25100,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25100,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25100,"methodology":"case rate"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1793","type":"APR-DRG"}],"standard_charges":[{"minimum":30528,"maximum":30528,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":30528,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":30528,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":30528,"methodology":"case rate"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1794","type":"APR-DRG"}],"standard_charges":[{"minimum":41327,"maximum":41327,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":41327,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":41327,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":41327,"methodology":"case rate"}]}]},{"description":"SKIN TISSUE PROCEDURE","code_information":[{"code":"17999","type":"CPT"}],"standard_charges":[{"minimum":134.08,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":190.43,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":188.58,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":186.73,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":184.88,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY NEOPLASMS WITH MCC","code_information":[{"code":"180","type":"MS-DRG"}],"standard_charges":[{"minimum":24677.23,"maximum":44893.18,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36050.39,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":27038.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":27038.64,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24677.23,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":24677.23,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":25356.86,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30111,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":24860,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":34218,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43585.61,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44021.47,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":44893.18,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44457.33,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43585.61,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43585.61,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43585.61,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44021.47,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43585.61,"methodology":"case rate"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1801","type":"APR-DRG"}],"standard_charges":[{"minimum":7462,"maximum":7462,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7462,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7462,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7462,"methodology":"case rate"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1802","type":"APR-DRG"}],"standard_charges":[{"minimum":9888,"maximum":9888,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9888,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9888,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9888,"methodology":"case rate"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1803","type":"APR-DRG"}],"standard_charges":[{"minimum":14161,"maximum":14161,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14161,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14161,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14161,"methodology":"case rate"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1804","type":"APR-DRG"}],"standard_charges":[{"minimum":26540,"maximum":26540,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26540,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26540,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26540,"methodology":"case rate"}]}]},{"description":"RESPIRATORY NEOPLASMS WITH CC","code_information":[{"code":"181","type":"MS-DRG"}],"standard_charges":[{"minimum":15632.32,"maximum":40092.15,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30432.27,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":22824.92,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":22824.92,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15632.32,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":15632.32,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16062.85,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19074,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":15748,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21676,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38924.41,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39313.66,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40092.15,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39702.9,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38924.41,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38924.41,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38924.41,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39313.66,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38924.41,"methodology":"case rate"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1811","type":"APR-DRG"}],"standard_charges":[{"minimum":8921,"maximum":8921,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8921,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8921,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8921,"methodology":"case rate"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1812","type":"APR-DRG"}],"standard_charges":[{"minimum":12942,"maximum":12942,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12942,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12942,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12942,"methodology":"case rate"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1813","type":"APR-DRG"}],"standard_charges":[{"minimum":20971,"maximum":20971,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":20971,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":20971,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":20971,"methodology":"case rate"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1814","type":"APR-DRG"}],"standard_charges":[{"minimum":35404,"maximum":35404,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":35404,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":35404,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":35404,"methodology":"case rate"}]}]},{"description":"RESPIRATORY NEOPLASMS WITHOUT CC/MCC","code_information":[{"code":"182","type":"MS-DRG"}],"standard_charges":[{"minimum":11340.56,"maximum":37814.09,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26556.06,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19917.67,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19917.67,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11340.56,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11340.56,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11652.89,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13838,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":11424,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":15725,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36712.7,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.83,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37814.09,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37446.96,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36712.7,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36712.7,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36712.7,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.83,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36712.7,"methodology":"case rate"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1821","type":"APR-DRG"}],"standard_charges":[{"minimum":12195,"maximum":12195,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12195,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12195,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12195,"methodology":"case rate"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1822","type":"APR-DRG"}],"standard_charges":[{"minimum":13671,"maximum":13671,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13671,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13671,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13671,"methodology":"case rate"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1823","type":"APR-DRG"}],"standard_charges":[{"minimum":16703,"maximum":16703,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16703,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16703,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16703,"methodology":"case rate"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1824","type":"APR-DRG"}],"standard_charges":[{"minimum":29883,"maximum":29883,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":29883,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":29883,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":29883,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST TRAUMA WITH MCC","code_information":[{"code":"183","type":"MS-DRG"}],"standard_charges":[{"minimum":19853.06,"maximum":43659.57,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26469.92,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":19853.06,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":19853.06,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22353.18,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":22353.18,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22968.81,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27275,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22518,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":30996,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42387.93,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42811.81,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43659.57,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43235.69,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42387.93,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42387.93,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42387.93,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42811.81,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42387.93,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1831","type":"APR-DRG"}],"standard_charges":[{"minimum":25564,"maximum":25564,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25564,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25564,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25564,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1832","type":"APR-DRG"}],"standard_charges":[{"minimum":26889,"maximum":26889,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26889,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26889,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26889,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1833","type":"APR-DRG"}],"standard_charges":[{"minimum":31974,"maximum":31974,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":31974,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":31974,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":31974,"methodology":"case rate"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1834","type":"APR-DRG"}],"standard_charges":[{"minimum":46493,"maximum":46493,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":46493,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":46493,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":46493,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST TRAUMA WITH CC","code_information":[{"code":"184","type":"MS-DRG"}],"standard_charges":[{"minimum":14933.82,"maximum":39721.39,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20089.32,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15067.46,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15067.46,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14933.82,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14933.82,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":15345.12,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18222,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":15044,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":20708,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38564.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38950.1,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39721.39,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39335.74,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38564.45,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38564.45,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38564.45,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38950.1,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38564.45,"methodology":"case rate"}]}]},{"description":"MAJOR CHEST TRAUMA WITHOUT CC/MCC","code_information":[{"code":"185","type":"MS-DRG"}],"standard_charges":[{"minimum":10728.67,"maximum":37489.3,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15252.82,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11439.98,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11439.98,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10728.67,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10728.67,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11024.15,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13091,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":10808,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14877,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36397.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36761.35,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37489.3,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37125.32,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36397.37,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36397.37,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36397.37,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36761.35,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36397.37,"methodology":"case rate"}]}]},{"description":"PLEURAL EFFUSION WITH MCC","code_information":[{"code":"186","type":"MS-DRG"}],"standard_charges":[{"minimum":20367.51,"maximum":43490.78,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27155.83,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":20367.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":20367.51,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22035.16,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":22035.16,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":22642.03,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26887,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":22198,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":30555,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":42224.05,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":42646.3,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":43490.78,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":43068.54,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":42224.05,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":42224.05,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":42224.05,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":42646.3,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":42224.05,"methodology":"case rate"}]}]},{"description":"PLEURAL EFFUSION WITH CC","code_information":[{"code":"187","type":"MS-DRG"}],"standard_charges":[{"minimum":14144.47,"maximum":39302.39,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22309.77,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16732.85,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16732.85,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14144.47,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14144.47,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14534.02,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17259,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":14249,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":19613,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38157.66,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38539.24,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39302.39,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38920.82,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38157.66,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38157.66,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38157.66,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38539.24,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38157.66,"methodology":"case rate"}]}]},{"description":"PLEURAL EFFUSION WITHOUT CC/MCC","code_information":[{"code":"188","type":"MS-DRG"}],"standard_charges":[{"minimum":10598.06,"maximum":37419.97,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18197.47,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13648.53,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13648.53,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10598.06,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10598.06,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10889.94,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12932,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":10676,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":14696,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36330.06,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36693.37,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37419.97,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37056.67,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36330.06,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36330.06,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36330.06,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36693.37,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36330.06,"methodology":"case rate"}]}]},{"description":"PULMONARY EDEMA AND RESPIRATORY FAILURE","code_information":[{"code":"189","type":"MS-DRG"}],"standard_charges":[{"minimum":17490.7,"maximum":41078.58,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26983.56,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":20238.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":20238.3,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17490.7,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":17490.7,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":17972.42,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21342,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":17620,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":24253,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":39882.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40280.94,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41078.58,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":40679.76,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":39882.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":39882.11,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":39882.11,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40280.94,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":39882.11,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC","code_information":[{"code":"190","type":"MS-DRG"}],"standard_charges":[{"minimum":15645.09,"maximum":40098.92,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21547.29,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16160.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16160.97,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15645.09,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":15645.09,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":16075.98,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19090,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":15761,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21694,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38930.99,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39320.3,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":40098.92,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39709.61,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38930.99,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38930.99,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38930.99,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39320.3,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38930.99,"methodology":"case rate"}]}]},{"description":"DRAINAGE OF BREAST LESION","code_information":[{"code":"19000","type":"CPT"}],"standard_charges":[{"minimum":44.35,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":91.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"DRAIN BREAST LESION ADD-ON","code_information":[{"code":"19001","type":"CPT"}],"standard_charges":[{"minimum":21.63,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":44.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.63,"methodology":"fee schedule"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1901","type":"APR-DRG"}],"standard_charges":[{"minimum":4848,"maximum":4848,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4848,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4848,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4848,"methodology":"case rate"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1902","type":"APR-DRG"}],"standard_charges":[{"minimum":5467,"maximum":5467,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5467,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5467,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5467,"methodology":"case rate"}]}]},{"description":"INCISION OF BREAST LESION","code_information":[{"code":"19020","type":"CPT"}],"standard_charges":[{"minimum":328.81,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":679.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":328.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":328.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":328.81,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1903","type":"APR-DRG"}],"standard_charges":[{"minimum":7270,"maximum":7270,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7270,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7270,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7270,"methodology":"case rate"}]}]},{"description":"INJECTION FOR BREAST X-RAY","code_information":[{"code":"19030","type":"CPT"}],"standard_charges":[{"minimum":79.68,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":378.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":378.1,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":378.1,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":165.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1904","type":"APR-DRG"}],"standard_charges":[{"minimum":11348,"maximum":11348,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11348,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11348,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11348,"methodology":"case rate"}]}]},{"description":"BX BREAST 1ST LESION STRTCTC","code_information":[{"code":"19081","type":"CPT"}],"standard_charges":[{"minimum":170.53,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":352.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BX BREAST ADD LESION STRTCTC","code_information":[{"code":"19082","type":"CPT"}],"standard_charges":[{"minimum":85.81,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":177.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.81,"methodology":"fee schedule"}]}]},{"description":"BX BREAST US PERC 1ST LES UNI","code_information":[{"code":"19083","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":770.09,"maximum":1187.101,"gross_charge":1453,"discounted_cash":581.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":770.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1187.11,"methodology":"fee schedule"}]}]},{"description":"BX BREAST US PERC 1ST LES UNI","code_information":[{"code":"19083","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":160.08,"maximum":1496.59,"gross_charge":1453,"discounted_cash":581.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":770.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1187.11,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1453,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1467.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1496.59,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1482.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1453,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1453,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1453,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1467.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1453,"methodology":"fee schedule"}]}]},{"description":"BX BRST US PERC EA ADD LES","code_information":[{"code":"19084","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":3153.5,"maximum":4861.15,"gross_charge":5950,"discounted_cash":2380,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3153.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4861.15,"methodology":"fee schedule"}]}]},{"description":"BX BRST US PERC EA ADD LES","code_information":[{"code":"19084","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":80.76,"maximum":4861.15,"gross_charge":5950,"discounted_cash":2380,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3153.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4861.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.76,"methodology":"fee schedule"}]}]},{"description":"BX BREAST 1ST LESION MR IMAG","code_information":[{"code":"19085","type":"CPT"}],"standard_charges":[{"minimum":186.76,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":385.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BX BREAST ADD LESION MR IMAG","code_information":[{"code":"19086","type":"CPT"}],"standard_charges":[{"minimum":93.74,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":193.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.74,"methodology":"fee schedule"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC","code_information":[{"code":"191","type":"MS-DRG"}],"standard_charges":[{"minimum":12053.25,"maximum":38192.37,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18194.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13646.14,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13646.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12053.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12053.25,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12385.21,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14707,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":12142,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":16713,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37450.77,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38192.37,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37821.57,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.97,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.97,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.97,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37450.77,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37079.97,"methodology":"case rate"}]}]},{"description":"BX BREAST PERCUT W/O IMAGE","code_information":[{"code":"19100","type":"CPT"}],"standard_charges":[{"minimum":71.75,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":148.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BIOPSY OF BREAST OPEN","code_information":[{"code":"19101","type":"CPT"}],"standard_charges":[{"minimum":234.35,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":484.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"CRYOSURG ABLATE FA EACH","code_information":[{"code":"19105","type":"CPT"}],"standard_charges":[{"minimum":217.76,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":450.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":217.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":217.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":217.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1911","type":"APR-DRG"}],"standard_charges":[{"minimum":5789,"maximum":5789,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5789,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5789,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5789,"methodology":"case rate"}]}]},{"description":"NIPPLE EXPLORATION","code_information":[{"code":"19110","type":"CPT"}],"standard_charges":[{"minimum":369.19,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":763.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"EXCISE BREAST DUCT FISTULA","code_information":[{"code":"19112","type":"CPT"}],"standard_charges":[{"minimum":337.82,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":698.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.82,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.82,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1912","type":"APR-DRG"}],"standard_charges":[{"minimum":6790,"maximum":6790,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6790,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6790,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6790,"methodology":"case rate"}]}]},{"description":"REMOVAL OF BREAST LESION","code_information":[{"code":"19120","type":"CPT"}],"standard_charges":[{"minimum":437.69,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":905.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":437.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":437.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":437.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"EXCISION BREAST LESION","code_information":[{"code":"19125","type":"CPT"}],"standard_charges":[{"minimum":484.2,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1000.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":484.2,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":484.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":484.2,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"EXCISION ADDL BREAST LESION","code_information":[{"code":"19126","type":"CPT"}],"standard_charges":[{"minimum":165.85,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":343.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":165.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":165.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":165.85,"methodology":"fee schedule"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1913","type":"APR-DRG"}],"standard_charges":[{"minimum":9052,"maximum":9052,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9052,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9052,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9052,"methodology":"case rate"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1914","type":"APR-DRG"}],"standard_charges":[{"minimum":14273,"maximum":14273,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14273,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14273,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14273,"methodology":"case rate"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC","code_information":[{"code":"192","type":"MS-DRG"}],"standard_charges":[{"minimum":9111.63,"maximum":36630.97,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15756.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11818.04,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11818.04,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9111.63,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9111.63,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":9362.58,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11118,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":9179,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":12634,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":35564.04,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":35919.69,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":36630.97,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36275.33,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":35564.04,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":35564.04,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":35564.04,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":35919.69,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":35564.04,"methodology":"case rate"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1921","type":"APR-DRG"}],"standard_charges":[{"minimum":6173,"maximum":6173,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6173,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6173,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6173,"methodology":"case rate"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1922","type":"APR-DRG"}],"standard_charges":[{"minimum":7744,"maximum":7744,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7744,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7744,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7744,"methodology":"case rate"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1923","type":"APR-DRG"}],"standard_charges":[{"minimum":11287,"maximum":11287,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11287,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11287,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11287,"methodology":"case rate"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1924","type":"APR-DRG"}],"standard_charges":[{"minimum":18291,"maximum":18291,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":18291,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":18291,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":18291,"methodology":"case rate"}]}]},{"description":"PERQ DEVICE BREAST 1ST IMAG","code_information":[{"code":"19281","type":"CPT"}],"standard_charges":[{"minimum":103.11,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":212.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.11,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.11,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"PERQ DEVICE BREAST EA IMAG","code_information":[{"code":"19282","type":"CPT"}],"standard_charges":[{"minimum":51.92,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":107.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.92,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV BREAST 1ST STRTCTC","code_information":[{"code":"19283","type":"CPT"}],"standard_charges":[{"minimum":103.47,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":214.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV BREAST ADD STRTCTC","code_information":[{"code":"19284","type":"CPT"}],"standard_charges":[{"minimum":51.92,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":107.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.92,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV BREAST 1ST US IMAG","code_information":[{"code":"19285","type":"CPT"}],"standard_charges":[{"minimum":88.33,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":182.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV BREAST ADD US IMAG","code_information":[{"code":"19286","type":"CPT"}],"standard_charges":[{"minimum":44.35,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV BREAST 1ST MR GUIDE","code_information":[{"code":"19287","type":"CPT"}],"standard_charges":[{"minimum":130.88,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":270.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.88,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"PERQ DEV BREAST ADD MR GUIDE","code_information":[{"code":"19288","type":"CPT"}],"standard_charges":[{"minimum":65.98,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":136.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.98,"methodology":"fee schedule"}]}]},{"description":"PREP TUM CAV IORT PRTL MAST","code_information":[{"code":"19294","type":"CPT"}],"standard_charges":[{"minimum":170.17,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":351.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.17,"methodology":"fee schedule"}]}]},{"description":"PLACE PO BREAST CATH FOR RAD","code_information":[{"code":"19296","type":"CPT"}],"standard_charges":[{"minimum":218.49,"maximum":9285.96,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7554,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":7554,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":451.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":9105.65,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":9285.96,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":9195.8,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":9105.65,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"}]}]},{"description":"PLACE BREAST CATH FOR RAD","code_information":[{"code":"19297","type":"CPT"}],"standard_charges":[{"minimum":97.71,"maximum":7554,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7554,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":7554,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":202.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.71,"methodology":"fee schedule"}]}]},{"description":"PLACE BREAST RAD TUBE/CATHS","code_information":[{"code":"19298","type":"CPT"}],"standard_charges":[{"minimum":333.14,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":688.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":333.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":333.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":333.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"SIMPLE PNEUMONIA AND PLEURISY WITH MCC","code_information":[{"code":"193","type":"MS-DRG"}],"standard_charges":[{"minimum":15914.51,"maximum":41791.46,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21218.69,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":15914.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":15914.51,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18833.74,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":18833.74,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":19352.44,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22981,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":18973,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":26115,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":40574.23,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":40979.98,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":41791.46,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41385.72,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":40574.23,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":40574.23,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":40574.23,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":40979.98,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":40574.23,"methodology":"case rate"}]}]},{"description":"REMOVAL OF BREAST TISSUE","code_information":[{"code":"19300","type":"CPT"}],"standard_charges":[{"minimum":455,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":940.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":455,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":455,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":455,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"PARTIAL MASTECTOMY","code_information":[{"code":"19301","type":"CPT"}],"standard_charges":[{"minimum":690.79,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1428.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":690.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":690.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":690.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"P-MASTECTOMY W/LN REMOVAL","code_information":[{"code":"19302","type":"CPT"}],"standard_charges":[{"minimum":948.58,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1961.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":948.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":948.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":948.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"MAST SIMPLE COMPLETE","code_information":[{"code":"19303","type":"CPT"}],"standard_charges":[{"minimum":1001.57,"maximum":6267.27,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2070.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1001.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1001.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1001.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"MAST RADICAL","code_information":[{"code":"19305","type":"CPT"}],"standard_charges":[{"minimum":1204.56,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2490.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3047,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3916,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1204.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1204.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1204.56,"methodology":"fee schedule"}]}]},{"description":"MAST RAD URBAN TYPE","code_information":[{"code":"19306","type":"CPT"}],"standard_charges":[{"minimum":1276.67,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2639.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3047,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3916,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1276.67,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1276.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1276.67,"methodology":"fee schedule"}]}]},{"description":"MAST MOD RAD","code_information":[{"code":"19307","type":"CPT"}],"standard_charges":[{"minimum":1234.12,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2551.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1234.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1234.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1234.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1931","type":"APR-DRG"}],"standard_charges":[{"minimum":5283,"maximum":5283,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5283,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5283,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5283,"methodology":"case rate"}]}]},{"description":"SUSPENSION OF BREAST","code_information":[{"code":"19316","type":"CPT"}],"standard_charges":[{"minimum":830.32,"maximum":6267.27,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1717.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":830.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":830.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":830.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"BREAST REDUCTION","code_information":[{"code":"19318","type":"CPT"}],"standard_charges":[{"minimum":1145.43,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2368.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1145.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1145.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1145.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1932","type":"APR-DRG"}],"standard_charges":[{"minimum":7094,"maximum":7094,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7094,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7094,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7094,"methodology":"case rate"}]}]},{"description":"ENLARGE BREAST","code_information":[{"code":"19324","type":"CPT"}],"standard_charges":[{"minimum":1185.8,"maximum":1185.8,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1185.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BREAST AUGMENTATION W/IMPLT","code_information":[{"code":"19325","type":"CPT"}],"standard_charges":[{"minimum":645.36,"maximum":9285.96,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7554,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":7554,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1334.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":645.36,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":645.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":645.36,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":9105.65,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":9285.96,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":9195.8,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":9105.65,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF BREAST IMPLANT","code_information":[{"code":"19328","type":"CPT"}],"standard_charges":[{"minimum":581.55,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1202.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":581.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":581.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":581.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1933","type":"APR-DRG"}],"standard_charges":[{"minimum":10930,"maximum":10930,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10930,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10930,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10930,"methodology":"case rate"}]}]},{"description":"REMOVAL OF IMPLANT MATERIAL","code_information":[{"code":"19330","type":"CPT"}],"standard_charges":[{"minimum":678.89,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1403.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":678.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":678.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":678.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1934","type":"APR-DRG"}],"standard_charges":[{"minimum":15695,"maximum":15695,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15695,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15695,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15695,"methodology":"case rate"}]}]},{"description":"IMMEDIATE BREAST PROSTHESIS","code_information":[{"code":"19340","type":"CPT"}],"standard_charges":[{"minimum":796.43,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1646.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":796.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":796.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":796.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"DELAYED BREAST PROSTHESIS","code_information":[{"code":"19342","type":"CPT"}],"standard_charges":[{"minimum":798.59,"maximum":9285.96,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1651.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":798.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":798.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":798.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":9105.65,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":9285.96,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":9195.8,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":9105.65,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":9015.49,"methodology":"fee schedule"}]}]},{"description":"BREAST RECONSTRUCTION","code_information":[{"code":"19350","type":"CPT"}],"standard_charges":[{"minimum":706.29,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1460.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":706.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":706.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":706.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"CORRECT INVERTED NIPPLE(S)","code_information":[{"code":"19355","type":"CPT"}],"standard_charges":[{"minimum":647.53,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1339.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":647.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":647.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":647.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"BREAST RECONSTRUCTION","code_information":[{"code":"19357","type":"CPT"}],"standard_charges":[{"minimum":1214.65,"maximum":17593.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2511.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1214.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1214.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1214.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":17081.18,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":17252,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":17593.62,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":17422.81,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":17081.18,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":17081.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":17081.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":17252,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":17081.18,"methodology":"fee schedule"}]}]},{"description":"BREAST RECONSTR W/LAT FLAP","code_information":[{"code":"19361","type":"CPT"}],"standard_charges":[{"minimum":1630.35,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3371.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3047,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3916,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1630.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1630.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1630.35,"methodology":"fee schedule"}]}]},{"description":"BREAST RECONSTRUCTION","code_information":[{"code":"19364","type":"CPT"}],"standard_charges":[{"minimum":2843.92,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5880.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2843.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2843.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2843.92,"methodology":"fee schedule"}]}]},{"description":"BREAST RECONSTRUCTION","code_information":[{"code":"19366","type":"CPT"}],"standard_charges":[{"minimum":3110.12,"maximum":3110.12,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3110.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"BREAST RECONSTRUCTION","code_information":[{"code":"19367","type":"CPT"}],"standard_charges":[{"minimum":1852.44,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3830.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1852.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1852.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1852.44,"methodology":"fee schedule"}]}]},{"description":"BREAST RECONSTRUCTION","code_information":[{"code":"19368","type":"CPT"}],"standard_charges":[{"minimum":2269.23,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4692.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2269.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2269.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2269.23,"methodology":"fee schedule"}]}]},{"description":"BREAST RECONSTRUCTION","code_information":[{"code":"19369","type":"CPT"}],"standard_charges":[{"minimum":2108.43,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4360.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2108.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2108.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2108.43,"methodology":"fee schedule"}]}]},{"description":"REVJ PERI-IMPLT CAPSULE BRST","code_information":[{"code":"19370","type":"CPT"}],"standard_charges":[{"minimum":704.13,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1456.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"PERI-IMPLT CAPSLC BRST COMPL","code_information":[{"code":"19371","type":"CPT"}],"standard_charges":[{"minimum":747.76,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1546.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":747.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":747.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":747.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"REVISE BREAST RECONSTRUCTION","code_information":[{"code":"19380","type":"CPT"}],"standard_charges":[{"minimum":846.9,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1751.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":846.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":846.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":846.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6267.27,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6206.42,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6145.57,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6084.72,"methodology":"fee schedule"}]}]},{"description":"DESIGN CUSTOM BREAST IMPLANT","code_information":[{"code":"19396","type":"CPT"}],"standard_charges":[{"minimum":148.54,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":307.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":148.54,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":148.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":148.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"SIMPLE PNEUMONIA AND PLEURISY WITH CC","code_information":[{"code":"194","type":"MS-DRG"}],"standard_charges":[{"minimum":11672.77,"maximum":37990.42,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17367.99,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":13026.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":13026.4,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11672.77,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11672.77,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11994.25,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14243,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":11759,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":16186,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36883.9,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37252.74,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37990.42,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37621.58,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36883.9,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36883.9,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36883.9,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37252.74,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36883.9,"methodology":"case rate"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1941","type":"APR-DRG"}],"standard_charges":[{"minimum":3167,"maximum":3167,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3167,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3167,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3167,"methodology":"case rate"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1942","type":"APR-DRG"}],"standard_charges":[{"minimum":4282,"maximum":4282,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4282,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4282,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4282,"methodology":"case rate"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1943","type":"APR-DRG"}],"standard_charges":[{"minimum":6045,"maximum":6045,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6045,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6045,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6045,"methodology":"case rate"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1944","type":"APR-DRG"}],"standard_charges":[{"minimum":9898,"maximum":9898,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9898,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9898,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9898,"methodology":"case rate"}]}]},{"description":"BREAST SURGERY PROCEDURE","code_information":[{"code":"19499","type":"CPT"}],"standard_charges":[{"minimum":2358.04,"maximum":3625.29,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2358.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2358.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2358.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3625.29,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3590.09,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3554.89,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3519.69,"methodology":"fee schedule"}]}]},{"description":"SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC","code_information":[{"code":"195","type":"MS-DRG"}],"standard_charges":[{"minimum":8881.64,"maximum":36508.89,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14251.07,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":10688.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":10688.64,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8881.64,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":8881.64,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":9126.25,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10837,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":8947,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":12316,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":35445.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":35799.98,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":36508.89,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36154.44,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":35445.52,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":35445.52,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":35445.52,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":35799.98,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":35445.52,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL LUNG DISEASE WITH MCC","code_information":[{"code":"196","type":"MS-DRG"}],"standard_charges":[{"minimum":16929.06,"maximum":46077.81,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22571.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16929.06,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16929.06,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26908.99,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":26908.99,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":27650.1,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32834,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":27108,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":37313,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44735.73,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":45183.09,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":46077.81,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45630.45,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44735.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44735.73,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44735.73,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":45183.09,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44735.73,"methodology":"case rate"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1961","type":"APR-DRG"}],"standard_charges":[{"minimum":2733,"maximum":2733,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2733,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2733,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2733,"methodology":"case rate"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1962","type":"APR-DRG"}],"standard_charges":[{"minimum":3747,"maximum":3747,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3747,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3747,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3747,"methodology":"case rate"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1963","type":"APR-DRG"}],"standard_charges":[{"minimum":5382,"maximum":5382,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5382,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5382,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5382,"methodology":"case rate"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1964","type":"APR-DRG"}],"standard_charges":[{"minimum":10975,"maximum":10975,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10975,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10975,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10975,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL LUNG DISEASE WITH CC","code_information":[{"code":"197","type":"MS-DRG"}],"standard_charges":[{"minimum":14074.45,"maximum":39311.44,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18765.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":14074.45,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":14074.45,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14161.51,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":14161.51,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":14551.53,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17280,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":14266,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":19637,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38166.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38548.11,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39311.44,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38929.77,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38166.44,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38166.44,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38166.44,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38548.11,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38166.44,"methodology":"case rate"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1971","type":"APR-DRG"}],"standard_charges":[{"minimum":3393,"maximum":3393,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3393,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3393,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3393,"methodology":"case rate"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1972","type":"APR-DRG"}],"standard_charges":[{"minimum":4406,"maximum":4406,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4406,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4406,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4406,"methodology":"case rate"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1973","type":"APR-DRG"}],"standard_charges":[{"minimum":6115,"maximum":6115,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6115,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6115,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6115,"methodology":"case rate"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1974","type":"APR-DRG"}],"standard_charges":[{"minimum":12757,"maximum":12757,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12757,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12757,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12757,"methodology":"case rate"}]}]},{"description":"INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC","code_information":[{"code":"198","type":"MS-DRG"}],"standard_charges":[{"minimum":11048.11,"maximum":37658.84,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15811.13,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11858.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11858.72,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11048.11,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11048.11,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":11352.38,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13481,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":11130,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":15320,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36561.98,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36927.6,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37658.84,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37293.22,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36561.98,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36561.98,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36561.98,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36927.6,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36561.98,"methodology":"case rate"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1981","type":"APR-DRG"}],"standard_charges":[{"minimum":3312,"maximum":3312,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3312,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3312,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3312,"methodology":"case rate"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1982","type":"APR-DRG"}],"standard_charges":[{"minimum":3860,"maximum":3860,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3860,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3860,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3860,"methodology":"case rate"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1983","type":"APR-DRG"}],"standard_charges":[{"minimum":5153,"maximum":5153,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5153,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5153,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5153,"methodology":"case rate"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1984","type":"APR-DRG"}],"standard_charges":[{"minimum":9996,"maximum":9996,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9996,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9996,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9996,"methodology":"case rate"}]}]},{"description":"PNEUMOTHORAX WITH MCC","code_information":[{"code":"199","type":"MS-DRG"}],"standard_charges":[{"minimum":22073.58,"maximum":45163.71,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29430.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":22073.58,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":22073.58,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25186.9,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25186.9,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":25880.57,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30733,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":25373,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":34925,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":43848.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44286.75,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45163.71,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44725.23,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":43848.26,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":43848.26,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":43848.26,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44286.75,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":43848.26,"methodology":"case rate"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1991","type":"APR-DRG"}],"standard_charges":[{"minimum":3303,"maximum":3303,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3303,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3303,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3303,"methodology":"case rate"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1992","type":"APR-DRG"}],"standard_charges":[{"minimum":3880,"maximum":3880,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3880,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3880,"methodology":"case rate"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1993","type":"APR-DRG"}],"standard_charges":[{"minimum":5422,"maximum":5422,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5422,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5422,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5422,"methodology":"case rate"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1994","type":"APR-DRG"}],"standard_charges":[{"minimum":8747,"maximum":8747,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8747,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8747,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8747,"methodology":"case rate"}]}]},{"description":"PNEUMOTHORAX WITH CC","code_information":[{"code":"200","type":"MS-DRG"}],"standard_charges":[{"minimum":15290.17,"maximum":39910.54,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21531.33,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16149.01,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16149.01,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15290.17,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":15290.17,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":15711.28,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18657,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":15403,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":21202,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":38748.09,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":39135.58,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39910.54,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":39523.06,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":38748.09,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":38748.09,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":38748.09,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":39135.58,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":38748.09,"methodology":"case rate"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2001","type":"APR-DRG"}],"standard_charges":[{"minimum":3550,"maximum":3550,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3550,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3550,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3550,"methodology":"case rate"}]}]},{"description":"ROOM ICU GENERAL","code_information":[{"code":"2001000921","type":"CDM"},{"code":"0200","type":"RC"}],"standard_charges":[{"minimum":3548.35,"maximum":5469.815,"gross_charge":6695,"discounted_cash":2678,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3548.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":5469.82,"methodology":"fee schedule"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2002","type":"APR-DRG"}],"standard_charges":[{"minimum":4493,"maximum":4493,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4493,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4493,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4493,"methodology":"case rate"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2003","type":"APR-DRG"}],"standard_charges":[{"minimum":6402,"maximum":6402,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6402,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6402,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6402,"methodology":"case rate"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2004","type":"APR-DRG"}],"standard_charges":[{"minimum":11805,"maximum":11805,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11805,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11805,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11805,"methodology":"case rate"}]}]},{"description":"PNEUMOTHORAX WITHOUT CC/MCC","code_information":[{"code":"201","type":"MS-DRG"}],"standard_charges":[{"minimum":10024.5,"maximum":37115.52,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17195.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":12897.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":12897.19,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10024.5,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":10024.5,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10300.59,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12232,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":10099,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13900,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36034.48,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36394.83,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37115.52,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36755.17,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36034.48,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36034.48,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36034.48,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36394.83,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36034.48,"methodology":"case rate"}]}]},{"description":"EXPLORE WOUND NECK","code_information":[{"code":"20100","type":"CPT"}],"standard_charges":[{"minimum":467.7,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1293.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":472.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":481.74,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":477.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":472.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"}]}]},{"description":"EXPLORE WOUND CHEST","code_information":[{"code":"20101","type":"CPT"}],"standard_charges":[{"minimum":218.85,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":452.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"EXPLORE WOUND ABDOMEN","code_information":[{"code":"20102","type":"CPT"}],"standard_charges":[{"minimum":265,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":547.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":265,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":265,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":265,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"EXPLORE WOUND EXTREMITY","code_information":[{"code":"20103","type":"CPT"}],"standard_charges":[{"minimum":360.9,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":746.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":360.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":360.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":360.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2011","type":"APR-DRG"}],"standard_charges":[{"minimum":2795,"maximum":2795,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2795,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2795,"methodology":"case rate"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2012","type":"APR-DRG"}],"standard_charges":[{"minimum":3674,"maximum":3674,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3674,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3674,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3674,"methodology":"case rate"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2013","type":"APR-DRG"}],"standard_charges":[{"minimum":5514,"maximum":5514,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5514,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5514,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5514,"methodology":"case rate"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2014","type":"APR-DRG"}],"standard_charges":[{"minimum":9930,"maximum":9930,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9930,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9930,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9930,"methodology":"case rate"}]}]},{"description":"EXCISE EPIPHYSEAL BAR","code_information":[{"code":"20150","type":"CPT"}],"standard_charges":[{"minimum":1051.33,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2174.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1051.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1051.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1051.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"BRONCHITIS AND ASTHMA WITH CC/MCC","code_information":[{"code":"202","type":"MS-DRG"}],"standard_charges":[{"minimum":8841.4,"maximum":39010.01,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11788.16,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8841.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8841.4,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13593.63,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":13593.63,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13968.01,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16587,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":13694,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":18849,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37873.79,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":38252.53,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":39010.01,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38631.27,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37873.79,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37873.79,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37873.79,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":38252.53,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37873.79,"methodology":"case rate"}]}]},{"description":"MUSCLE BIOPSY","code_information":[{"code":"20200","type":"CPT"}],"standard_charges":[{"minimum":98.79,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":204.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"DEEP MUSCLE BIOPSY","code_information":[{"code":"20205","type":"CPT"}],"standard_charges":[{"minimum":160.8,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":332.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.8,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"BIOPSY MUSCLE NEEDLE PERC","code_information":[{"code":"20206","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1773.91,"maximum":2734.499,"gross_charge":3347,"discounted_cash":1338.8,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1773.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2734.5,"methodology":"fee schedule"}]}]},{"description":"BIOPSY MUSCLE NEEDLE PERC","code_information":[{"code":"20206","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":59.49,"maximum":2734.499,"gross_charge":3347,"discounted_cash":1338.8,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":1773.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":2734.5,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BIOPSY BONE SUPER TROCAR/NDL","code_information":[{"code":"20220","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":3152.44,"maximum":4859.516,"gross_charge":5948,"discounted_cash":2379.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3152.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4859.52,"methodology":"fee schedule"}]}]},{"description":"BIOPSY BONE SUPER TROCAR/NDL","code_information":[{"code":"20220","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":91.58,"maximum":4859.516,"gross_charge":5948,"discounted_cash":2379.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3152.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4859.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BIOPSY BONE TROCAR/NEEDLE DEEP","code_information":[{"code":"20225","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":3152.44,"maximum":4859.516,"gross_charge":5948,"discounted_cash":2379.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3152.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4859.52,"methodology":"fee schedule"}]}]},{"description":"BIOPSY BONE TROCAR/NEEDLE DEEP","code_information":[{"code":"20225","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":134.48,"maximum":4859.516,"gross_charge":5948,"discounted_cash":2379.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3152.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4859.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BONE BIOPSY OPEN SUPERFICIAL","code_information":[{"code":"20240","type":"CPT"}],"standard_charges":[{"minimum":146.02,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":302.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"BONE BIOPSY OPEN DEEP","code_information":[{"code":"20245","type":"CPT"}],"standard_charges":[{"minimum":359.1,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":742.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.1,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.1,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"OPEN BONE BIOPSY","code_information":[{"code":"20250","type":"CPT"}],"standard_charges":[{"minimum":406.69,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":840.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":406.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":406.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":406.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"OPEN BONE BIOPSY","code_information":[{"code":"20251","type":"CPT"}],"standard_charges":[{"minimum":441.3,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":912.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":441.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":441.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":441.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"BRONCHITIS AND ASTHMA WITHOUT CC/MCC","code_information":[{"code":"203","type":"MS-DRG"}],"standard_charges":[{"minimum":6946.3,"maximum":37031.12,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9261.44,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":6946.3,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":6946.3,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9865.5,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":9865.5,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":10137.2,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12038,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":9938,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":13680,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":35952.54,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":36312.07,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37031.12,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":36671.6,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":35952.54,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":35952.54,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":35952.54,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":36312.07,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":35952.54,"methodology":"case rate"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2031","type":"APR-DRG"}],"standard_charges":[{"minimum":3437,"maximum":3437,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3437,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3437,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3437,"methodology":"case rate"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2032","type":"APR-DRG"}],"standard_charges":[{"minimum":3905,"maximum":3905,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3905,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3905,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3905,"methodology":"case rate"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2033","type":"APR-DRG"}],"standard_charges":[{"minimum":4846,"maximum":4846,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4846,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4846,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4846,"methodology":"case rate"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2034","type":"APR-DRG"}],"standard_charges":[{"minimum":6804,"maximum":6804,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6804,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6804,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6804,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SIGNS AND SYMPTOMS","code_information":[{"code":"204","type":"MS-DRG"}],"standard_charges":[{"minimum":9896.62,"maximum":37995.7,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13195.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":9896.62,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":9896.62,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11682.71,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":11682.71,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":12004.47,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14255,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":11769,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":16200,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":36889.02,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37257.92,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":37995.7,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":37626.81,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":36889.02,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":36889.02,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":36889.02,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37257.92,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":36889.02,"methodology":"case rate"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2041","type":"APR-DRG"}],"standard_charges":[{"minimum":3761,"maximum":3761,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3761,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3761,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3761,"methodology":"case rate"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2042","type":"APR-DRG"}],"standard_charges":[{"minimum":4220,"maximum":4220,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4220,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4220,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4220,"methodology":"case rate"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2043","type":"APR-DRG"}],"standard_charges":[{"minimum":5348,"maximum":5348,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5348,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5348,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5348,"methodology":"case rate"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2044","type":"APR-DRG"}],"standard_charges":[{"minimum":8623,"maximum":8623,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8623,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8623,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8623,"methodology":"case rate"}]}]},{"description":"OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC","code_information":[{"code":"205","type":"MS-DRG"}],"standard_charges":[{"minimum":16058.08,"maximum":45436.51,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21410.1,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":16058.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":16058.08,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25700.83,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25700.83,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":26408.66,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":25891,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":35638,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44113.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44554.25,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45436.51,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":44995.38,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44113.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44113.11,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44113.11,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44554.25,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44113.11,"methodology":"case rate"}]}]},{"description":"INJECTION OF SINUS TRACT","code_information":[{"code":"20500","type":"CPT"}],"standard_charges":[{"minimum":93.38,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":193.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.38,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"INJECT SINUS TRACT FOR X-RAY","code_information":[{"code":"20501","type":"CPT"}],"standard_charges":[{"minimum":38.22,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":279.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":279.93,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":279.93,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":79.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.22,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.22,"methodology":"fee schedule"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2051","type":"APR-DRG"}],"standard_charges":[{"minimum":3435,"maximum":3435,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3435,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3435,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3435,"methodology":"case rate"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2052","type":"APR-DRG"}],"standard_charges":[{"minimum":4332,"maximum":4332,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4332,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4332,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4332,"methodology":"case rate"}]}]},{"description":"REMOVAL OF FOREIGN BODY","code_information":[{"code":"20520","type":"CPT"}],"standard_charges":[{"minimum":154.31,"maximum":2628,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":318.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":154.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":154.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":154.31,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF FOREIGN BODY","code_information":[{"code":"20525","type":"CPT"}],"standard_charges":[{"minimum":258.87,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":535.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":258.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":258.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":258.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"THER INJECTION CARP TUNNEL","code_information":[{"code":"20526","type":"CPT"}],"standard_charges":[{"minimum":59.49,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":123.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"INJ DUPUYTREN CORD W/ENZYME","code_information":[{"code":"20527","type":"CPT"}],"standard_charges":[{"minimum":68.5,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":141.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.5,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.5,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2053","type":"APR-DRG"}],"standard_charges":[{"minimum":6357,"maximum":6357,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6357,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6357,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6357,"methodology":"case rate"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2054","type":"APR-DRG"}],"standard_charges":[{"minimum":12582,"maximum":12582,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12582,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12582,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12582,"methodology":"case rate"}]}]},{"description":"INJ TENDON SHEATH/LIGAMENT","code_information":[{"code":"20550","type":"CPT"}],"standard_charges":[{"minimum":40.74,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":84.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"INJ TENDON ORIGIN/INSERTION","code_information":[{"code":"20551","type":"CPT"}],"standard_charges":[{"minimum":40.74,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":627.63,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":84.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"INJ TRIGGER POINT 1/2 MUSCL","code_information":[{"code":"20552","type":"CPT"}],"standard_charges":[{"minimum":38.94,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":158.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":158.3,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":158.3,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":80.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"INJECT TRIGGER POINTS 3/>","code_information":[{"code":"20553","type":"CPT"}],"standard_charges":[{"minimum":44.35,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":180.04,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":180.04,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":91.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"PLACE NDL MUSC/TIS FOR RT","code_information":[{"code":"20555","type":"CPT"}],"standard_charges":[{"minimum":351.52,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":727.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":351.52,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":351.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":351.52,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"NDL INSJ W/O NJX 1 OR 2 MUSC","code_information":[{"code":"20560","type":"CPT"}],"standard_charges":[{"minimum":25.55,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":64.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":64.75,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":64.75,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":32.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":25.81,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":26.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":25.81,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"}]}]},{"description":"NDL INSJ W/O NJX 3+ MUSC","code_information":[{"code":"20561","type":"CPT"}],"standard_charges":[{"minimum":25.55,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":97.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":97.72,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":48.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":25.81,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":26.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":25.81,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"}]}]},{"description":"OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC","code_information":[{"code":"206","type":"MS-DRG"}],"standard_charges":[{"minimum":11849.15,"maximum":38678.43,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15798.37,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":11849.15,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":11849.15,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12968.96,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":12968.96,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":13326.14,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15825,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":13065,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":17983,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":37551.87,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":37927.39,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":38678.43,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":38302.91,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":37551.87,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":37551.87,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":37551.87,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":37927.39,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":37551.87,"methodology":"case rate"}]}]},{"description":"DRAIN/INJ JOINT/BURSA W/O US","code_information":[{"code":"20600","type":"CPT"}],"standard_charges":[{"minimum":37.14,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":76.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"US ARTHROCENT ASP SMALL JT/BUR","code_information":[{"code":"20604","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":624.87,"maximum":963.243,"gross_charge":1179,"discounted_cash":471.6,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":624.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":963.25,"methodology":"fee schedule"}]}]},{"description":"US ARTHROCENT ASP SMALL JT/BUR","code_information":[{"code":"20604","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":47.95,"maximum":963.243,"gross_charge":1179,"discounted_cash":471.6,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":624.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":963.25,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"DRAIN/INJ JOINT/BURSA W/O US","code_information":[{"code":"20605","type":"CPT"}],"standard_charges":[{"minimum":38.58,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":80.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"US ARTHROCEN ASP INTERM JT/BUR","code_information":[{"code":"20606","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":610.03,"maximum":940.367,"gross_charge":1151,"discounted_cash":460.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":610.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":940.37,"methodology":"fee schedule"}]}]},{"description":"US ARTHROCEN ASP INTERM JT/BUR","code_information":[{"code":"20606","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":54.44,"maximum":940.367,"gross_charge":1151,"discounted_cash":460.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":610.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":940.37,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":659.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":666.29,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":679.49,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":672.89,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":659.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":659.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":659.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":666.29,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":659.69,"methodology":"fee schedule"}]}]},{"description":"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2061","type":"APR-DRG"}],"standard_charges":[{"minimum":4767,"maximum":4767,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4767,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4767,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4767,"methodology":"case rate"}]}]},{"description":"ARTHRO ASP MAJOR JT WO US UNI","code_information":[{"code":"20610","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":97.42,"maximum":8982,"gross_charge":1174,"discounted_cash":469.6,"setting":"inpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":622.22,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":97.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":959.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":8982,"methodology":"case rate"}]}]},{"description":"ARTHRO ASP MAJOR JT WO US UNI","code_information":[{"code":"20610","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":47.23,"maximum":8982,"gross_charge":1174,"discounted_cash":469.6,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":622.22,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":97.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":959.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.23,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"ROOM INTER ICU/TELE","code_information":[{"code":"2061000922","type":"CDM"},{"code":"0206","type":"RC"}],"standard_charges":[{"minimum":2421.04,"maximum":3732.056,"gross_charge":4568,"discounted_cash":1827.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":2421.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":3732.06,"methodology":"fee schedule"}]}]},{"description":"US ARTHROCEN ASP MAJOR JT/BUR","code_information":[{"code":"20611","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":735.11,"maximum":1133.179,"gross_charge":1387,"discounted_cash":554.8,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":735.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1133.18,"methodology":"fee schedule"}]}]},{"description":"US ARTHROCEN ASP MAJOR JT/BUR","code_information":[{"code":"20611","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":62.73,"maximum":1133.179,"gross_charge":1387,"discounted_cash":554.8,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":735.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":1133.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.73,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.73,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"ASPIRATE/INJ GANGLION CYST","code_information":[{"code":"20612","type":"CPT"}],"standard_charges":[{"minimum":42.9,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1774.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1774.01,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1774.01,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":88.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":42.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":42.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":42.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":286.73,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":283.94,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":281.16,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":278.37,"methodology":"fee schedule"}]}]},{"description":"TREATMENT OF BONE CYST","code_information":[{"code":"20615","type":"CPT"}],"standard_charges":[{"minimum":169.45,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":350.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.45,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2062","type":"APR-DRG"}],"standard_charges":[{"minimum":4911,"maximum":4911,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4911,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4911,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4911,"methodology":"case rate"}]}]},{"description":"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2063","type":"APR-DRG"}],"standard_charges":[{"minimum":7157,"maximum":7157,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7157,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7157,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7157,"methodology":"case rate"}]}]},{"description":"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2064","type":"APR-DRG"}],"standard_charges":[{"minimum":15363,"maximum":15363,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15363,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15363,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15363,"methodology":"case rate"}]}]},{"description":"INSERT AND REMOVE BONE PIN","code_information":[{"code":"20650","type":"CPT"}],"standard_charges":[{"minimum":171.98,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":355.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":171.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":171.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":171.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"APPLY REM FIXATION DEVICE","code_information":[{"code":"20660","type":"CPT"}],"standard_charges":[{"minimum":250.93,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":519,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":250.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":250.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":250.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"APPLICATION OF HEAD BRACE","code_information":[{"code":"20661","type":"CPT"}],"standard_charges":[{"minimum":542.97,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1122.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":542.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":542.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":542.97,"methodology":"fee schedule"}]}]},{"description":"APPLICATION OF PELVIS BRACE","code_information":[{"code":"20662","type":"CPT"}],"standard_charges":[{"minimum":549.46,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1135.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":549.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":549.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":549.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"APPLICATION OF THIGH BRACE","code_information":[{"code":"20663","type":"CPT"}],"standard_charges":[{"minimum":506.2,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1046.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":506.2,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":506.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":506.2,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"APPLICATION OF HALO","code_information":[{"code":"20664","type":"CPT"}],"standard_charges":[{"minimum":929.47,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1921.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":929.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":929.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":929.47,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF FIXATION DEVICE","code_information":[{"code":"20665","type":"CPT"}],"standard_charges":[{"minimum":102.39,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":211.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.39,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":398.16,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":394.3,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":390.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF SUPPORT IMPLANT","code_information":[{"code":"20670","type":"CPT"}],"standard_charges":[{"minimum":151.79,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":313.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF SUPPORT IMPLANT","code_information":[{"code":"20680","type":"CPT"}],"standard_charges":[{"minimum":440.22,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":909.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":440.22,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":440.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":440.22,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"APPLY BONE FIXATION DEVICE","code_information":[{"code":"20690","type":"CPT"}],"standard_charges":[{"minimum":626.25,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1295.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":626.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":626.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":626.25,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"APPLY BONE FIXATION DEVICE","code_information":[{"code":"20692","type":"CPT"}],"standard_charges":[{"minimum":1178.24,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2436.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1178.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1178.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1178.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"ADJUST BONE FIXATION DEVICE","code_information":[{"code":"20693","type":"CPT"}],"standard_charges":[{"minimum":466.18,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":963.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":466.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":466.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":466.18,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE BONE FIXATION DEVICE","code_information":[{"code":"20694","type":"CPT"}],"standard_charges":[{"minimum":359.46,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":742.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":359.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"COMP MULTIPLANE EXT FIXATION","code_information":[{"code":"20696","type":"CPT"}],"standard_charges":[{"minimum":1228.35,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2539.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1228.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1228.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1228.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"COMP EXT FIXATE STRUT CHANGE","code_information":[{"code":"20697","type":"CPT"}],"standard_charges":[{"minimum":1468.69,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3941.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1905.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1905.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1905.8,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS","code_information":[{"code":"207","type":"MS-DRG"}],"standard_charges":[{"minimum":81409.29,"maximum":135991,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122874.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":92158.69,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":92158.69,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98072.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":98072.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":100773.9,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":119667,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":98798,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":135991,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":81409.29,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":82223.39,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":83851.57,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":83037.48,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":81409.29,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":81409.29,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":81409.29,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":82223.39,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":81409.29,"methodology":"case rate"}]}]},{"description":"MNL PREPINSJ DP RX DLVR DEV","code_information":[{"code":"20700","type":"CPT"}],"standard_charges":[{"minimum":87.97,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":182.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.97,"methodology":"fee schedule"}]}]},{"description":"RMVL DEEP RX DELIVERY DEVICE","code_information":[{"code":"20701","type":"CPT"}],"standard_charges":[{"minimum":67.42,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":139.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.42,"methodology":"fee schedule"}]}]},{"description":"MNL PREPINSJ IMED RX DEV","code_information":[{"code":"20702","type":"CPT"}],"standard_charges":[{"minimum":148.18,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":306.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":148.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":148.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":148.18,"methodology":"fee schedule"}]}]},{"description":"RMVL IMED RX DELIVERY DEVICE","code_information":[{"code":"20703","type":"CPT"}],"standard_charges":[{"minimum":107.08,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":221.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":107.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":107.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":107.08,"methodology":"fee schedule"}]}]},{"description":"MNL PREPINSJ I-ARTIC RX DEV","code_information":[{"code":"20704","type":"CPT"}],"standard_charges":[{"minimum":152.87,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":316.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.87,"methodology":"fee schedule"}]}]},{"description":"RMVL I-ARTIC RX DELIVERY DEV","code_information":[{"code":"20705","type":"CPT"}],"standard_charges":[{"minimum":129.79,"maximum":1829,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":268.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.79,"methodology":"fee schedule"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2071","type":"APR-DRG"}],"standard_charges":[{"minimum":3409,"maximum":3409,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3409,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3409,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3409,"methodology":"case rate"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2072","type":"APR-DRG"}],"standard_charges":[{"minimum":4339,"maximum":4339,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4339,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4339,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4339,"methodology":"case rate"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2073","type":"APR-DRG"}],"standard_charges":[{"minimum":6272,"maximum":6272,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6272,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6272,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6272,"methodology":"case rate"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2074","type":"APR-DRG"}],"standard_charges":[{"minimum":11019,"maximum":11019,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11019,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11019,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11019,"methodology":"case rate"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS","code_information":[{"code":"208","type":"MS-DRG"}],"standard_charges":[{"minimum":34449.14,"maximum":53227,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45930.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":34449.14,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":34449.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38385.85,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":38385.85,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":39443.03,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46838,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":38670,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":53227,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":50650.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":51156.71,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":52169.71,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":51663.21,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":50650.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":50650.2,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":50650.2,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":51156.71,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":50650.2,"methodology":"case rate"}]}]},{"description":"REPLANTATION ARM COMPLETE","code_information":[{"code":"20802","type":"CPT"}],"standard_charges":[{"minimum":2861.23,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5916.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2861.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2861.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2861.23,"methodology":"fee schedule"}]}]},{"description":"REPLANT FOREARM COMPLETE","code_information":[{"code":"20805","type":"CPT"}],"standard_charges":[{"minimum":3274,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":7028.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3398.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3398.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3398.79,"methodology":"fee schedule"}]}]},{"description":"REPLANTATION HAND COMPLETE","code_information":[{"code":"20808","type":"CPT"}],"standard_charges":[{"minimum":3274,"maximum":8475.98,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":8475.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4098.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4098.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4098.96,"methodology":"fee schedule"}]}]},{"description":"REPLANTATION DIGIT COMPLETE","code_information":[{"code":"20816","type":"CPT"}],"standard_charges":[{"minimum":2142.68,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4430.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2142.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2142.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2142.68,"methodology":"fee schedule"}]}]},{"description":"REPLANTATION DIGIT COMPLETE","code_information":[{"code":"20822","type":"CPT"}],"standard_charges":[{"minimum":1468.69,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3827.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1851,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1851,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1851,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"REPLANTATION THUMB COMPLETE","code_information":[{"code":"20824","type":"CPT"}],"standard_charges":[{"minimum":2146.64,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4438.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2146.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2146.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2146.64,"methodology":"fee schedule"}]}]},{"description":"REPLANTATION THUMB COMPLETE","code_information":[{"code":"20827","type":"CPT"}],"standard_charges":[{"minimum":1901.12,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3931,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1901.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1901.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1901.12,"methodology":"fee schedule"}]}]},{"description":"REPLANTATION FOOT COMPLETE","code_information":[{"code":"20838","type":"CPT"}],"standard_charges":[{"minimum":2904.85,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6006.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2904.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2904.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2904.85,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF BONE FOR GRAFT","code_information":[{"code":"20900","type":"CPT"}],"standard_charges":[{"minimum":189.64,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":391.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF BONE FOR GRAFT","code_information":[{"code":"20902","type":"CPT"}],"standard_charges":[{"minimum":287.71,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":594.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":287.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":287.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":287.71,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE CARTILAGE FOR GRAFT","code_information":[{"code":"20910","type":"CPT"}],"standard_charges":[{"minimum":501.15,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1036.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":501.15,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":501.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":501.15,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":612.64,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":606.69,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":600.74,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":594.79,"methodology":"fee schedule"}]}]},{"description":"REMOVE CARTILAGE FOR GRAFT","code_information":[{"code":"20912","type":"CPT"}],"standard_charges":[{"minimum":507.64,"maximum":3430.45,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1049.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":507.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":507.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":507.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3397.15,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3363.84,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3330.53,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF FASCIA FOR GRAFT","code_information":[{"code":"20920","type":"CPT"}],"standard_charges":[{"minimum":421.83,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":872.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":421.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":421.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":421.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF FASCIA FOR GRAFT","code_information":[{"code":"20922","type":"CPT"}],"standard_charges":[{"minimum":517.01,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1068.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":517.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":517.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":517.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF TENDON FOR GRAFT","code_information":[{"code":"20924","type":"CPT"}],"standard_charges":[{"minimum":531.07,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1098.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"SP BONE ALGRFT MORSEL ADD-ON","code_information":[{"code":"20930","type":"CPT"}],"standard_charges":[{"minimum":252.93,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":252.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SP BONE ALGRFT STRUCT ADD-ON","code_information":[{"code":"20931","type":"CPT"}],"standard_charges":[{"minimum":114.29,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":236.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.29,"methodology":"fee schedule"}]}]},{"description":"OSTEOART ALGRFT W/SURF  B1","code_information":[{"code":"20932","type":"CPT"}],"standard_charges":[{"minimum":784.17,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1621.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.17,"methodology":"fee schedule"}]}]},{"description":"HEMICRT INTRCLRY ALGRFT PRTL","code_information":[{"code":"20933","type":"CPT"}],"standard_charges":[{"minimum":719.99,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1488.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":719.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":719.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":719.99,"methodology":"fee schedule"}]}]},{"description":"INTERCALARY ALGRFT COMPL","code_information":[{"code":"20934","type":"CPT"}],"standard_charges":[{"minimum":783.81,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1620.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.81,"methodology":"fee schedule"}]}]},{"description":"SP BONE AGRFT LOCAL ADD-ON","code_information":[{"code":"20936","type":"CPT"}],"standard_charges":[{"minimum":269.59,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":269.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SP BONE AGRFT MORSEL ADD-ON","code_information":[{"code":"20937","type":"CPT"}],"standard_charges":[{"minimum":173.42,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":358.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.42,"methodology":"fee schedule"}]}]},{"description":"SP BONE AGRFT STRUCT ADD-ON","code_information":[{"code":"20938","type":"CPT"}],"standard_charges":[{"minimum":189.28,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":391.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.28,"methodology":"fee schedule"}]}]},{"description":"BONE MARROW ASPIR BONE GRFG","code_information":[{"code":"20939","type":"CPT"}],"standard_charges":[{"minimum":72.83,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":150.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":72.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":72.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":72.83,"methodology":"fee schedule"}]}]},{"description":"FLUID PRESSURE MUSCLE","code_information":[{"code":"20950","type":"CPT"}],"standard_charges":[{"minimum":91.58,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":356.52,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":189.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"FIBULA BONE GRAFT MICROVASC","code_information":[{"code":"20955","type":"CPT"}],"standard_charges":[{"minimum":2577.13,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5329.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2577.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2577.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2577.13,"methodology":"fee schedule"}]}]},{"description":"ILIAC BONE GRAFT MICROVASC","code_information":[{"code":"20956","type":"CPT"}],"standard_charges":[{"minimum":2752.71,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5691.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2752.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2752.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2752.71,"methodology":"fee schedule"}]}]},{"description":"MT BONE GRAFT MICROVASC","code_information":[{"code":"20957","type":"CPT"}],"standard_charges":[{"minimum":2866.64,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5927.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2866.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2866.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2866.64,"methodology":"fee schedule"}]}]},{"description":"OTHER BONE GRAFT MICROVASC","code_information":[{"code":"20962","type":"CPT"}],"standard_charges":[{"minimum":2782.63,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5754.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2782.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2782.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2782.63,"methodology":"fee schedule"}]}]},{"description":"BONE/SKIN GRAFT MICROVASC","code_information":[{"code":"20969","type":"CPT"}],"standard_charges":[{"minimum":2844.64,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5882.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2844.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2844.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2844.64,"methodology":"fee schedule"}]}]},{"description":"BONE/SKIN GRAFT ILIAC CREST","code_information":[{"code":"20970","type":"CPT"}],"standard_charges":[{"minimum":2967.95,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6137.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2967.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2967.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2967.95,"methodology":"fee schedule"}]}]},{"description":"BONE/SKIN GRAFT METATARSAL","code_information":[{"code":"20972","type":"CPT"}],"standard_charges":[{"minimum":2959.66,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6120.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2959.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2959.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2959.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"BONE/SKIN GRAFT GREAT TOE","code_information":[{"code":"20973","type":"CPT"}],"standard_charges":[{"minimum":3060,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6464.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3126.22,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3126.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3126.22,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"ELECTRICAL BONE STIMULATION","code_information":[{"code":"20974","type":"CPT"}],"standard_charges":[{"minimum":53,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":313.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":313.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":313.43,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":109.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":81.09,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":81.91,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":83.53,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":82.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":81.09,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":81.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":81.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":81.91,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":81.09,"methodology":"fee schedule"}]}]},{"description":"ELECTRICAL BONE STIMULATION","code_information":[{"code":"20975","type":"CPT"}],"standard_charges":[{"minimum":182.07,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":376.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.07,"methodology":"fee schedule"}]}]},{"description":"US BONE STIMULATION","code_information":[{"code":"20979","type":"CPT"}],"standard_charges":[{"minimum":25.55,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":163.08,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":69.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":25.81,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":26.32,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":26.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":25.81,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":25.55,"methodology":"fee schedule"}]}]},{"description":"ABLATE BONE TUMOR(S) PERQ","code_information":[{"code":"20982","type":"CPT"}],"standard_charges":[{"minimum":381.09,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":788.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"ABLATE BONE TUMOR(S) PERQ","code_information":[{"code":"20983","type":"CPT"}],"standard_charges":[{"minimum":355.13,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":734.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":355.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":355.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":355.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"CPTR-ASST DIR MS PX","code_information":[{"code":"20985","type":"CPT"}],"standard_charges":[{"minimum":311.5,"maximum":1022.31,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1022.31,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1022.31,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1022.31,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":311.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"MUSCULOSKELETAL SURGERY","code_information":[{"code":"20999","type":"CPT"}],"standard_charges":[{"minimum":153.97,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"INCISION OF JAW JOINT","code_information":[{"code":"21010","type":"CPT"}],"standard_charges":[{"minimum":780.93,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1614.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":780.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":780.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":780.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"EXC FACE LES SC <2 CM","code_information":[{"code":"21011","type":"CPT"}],"standard_charges":[{"minimum":273.29,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":564.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":273.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":273.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":273.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC FACE LES SBQ 2 CM/>","code_information":[{"code":"21012","type":"CPT"}],"standard_charges":[{"minimum":356.57,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":737.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":356.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":356.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":356.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC FACE TUM DEEP < 2 CM","code_information":[{"code":"21013","type":"CPT"}],"standard_charges":[{"minimum":423.27,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":875.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC FACE TUM DEEP 2 CM/>","code_information":[{"code":"21014","type":"CPT"}],"standard_charges":[{"minimum":549.1,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1135.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":549.1,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":549.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":549.1,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT FACE/SCALP TUM < 2 CM","code_information":[{"code":"21015","type":"CPT"}],"standard_charges":[{"minimum":733.69,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1517.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":733.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":733.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":733.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT FACE/SCALP TUM 2 CM/>","code_information":[{"code":"21016","type":"CPT"}],"standard_charges":[{"minimum":1057.1,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2186.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1057.1,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1057.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1057.1,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXCISION OF BONE LOWER JAW","code_information":[{"code":"21025","type":"CPT"}],"standard_charges":[{"minimum":692.95,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1432.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":692.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":692.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":692.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"EXCISION OF FACIAL BONE(S)","code_information":[{"code":"21026","type":"CPT"}],"standard_charges":[{"minimum":448.51,"maximum":5630.87,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":927.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":448.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":448.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":448.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"CONTOUR OF FACE BONE LESION","code_information":[{"code":"21029","type":"CPT"}],"standard_charges":[{"minimum":653.29,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1350.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":653.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":653.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":653.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"EXCISE MAX/ZYGOMA B9 TUMOR","code_information":[{"code":"21030","type":"CPT"}],"standard_charges":[{"minimum":378.56,"maximum":5630.87,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":782.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":378.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":378.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":378.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REMOVE EXOSTOSIS MANDIBLE","code_information":[{"code":"21031","type":"CPT"}],"standard_charges":[{"minimum":285.19,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":590.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":285.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":285.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":285.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"REMOVE EXOSTOSIS MAXILLA","code_information":[{"code":"21032","type":"CPT"}],"standard_charges":[{"minimum":272.57,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":563.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":272.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":272.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":272.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"EXCISE MAX/ZYGOMA MAL TUMOR","code_information":[{"code":"21034","type":"CPT"}],"standard_charges":[{"minimum":1183.29,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2446.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1183.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1183.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1183.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"EXCISE MANDIBLE LESION","code_information":[{"code":"21040","type":"CPT"}],"standard_charges":[{"minimum":381.81,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":789.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.81,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF JAW BONE LESION","code_information":[{"code":"21044","type":"CPT"}],"standard_charges":[{"minimum":906.39,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1874.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.39,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"EXTENSIVE JAW SURGERY","code_information":[{"code":"21045","type":"CPT"}],"standard_charges":[{"minimum":1260.8,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2607.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1260.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1260.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1260.8,"methodology":"fee schedule"}]}]},{"description":"REMOVE MANDIBLE CYST COMPLEX","code_information":[{"code":"21046","type":"CPT"}],"standard_charges":[{"minimum":1038.35,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2147.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1038.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1038.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1038.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"EXCISE LWR JAW CYST W/REPAIR","code_information":[{"code":"21047","type":"CPT"}],"standard_charges":[{"minimum":1276.67,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2639.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1276.67,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1276.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1276.67,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REMOVE MAXILLA CYST COMPLEX","code_information":[{"code":"21048","type":"CPT"}],"standard_charges":[{"minimum":1045.56,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2162.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1045.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1045.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1045.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"EXCIS UPPR JAW CYST W/REPAIR","code_information":[{"code":"21049","type":"CPT"}],"standard_charges":[{"minimum":1209.24,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2500.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1209.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1209.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1209.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF JAW JOINT","code_information":[{"code":"21050","type":"CPT"}],"standard_charges":[{"minimum":908.56,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":908.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":908.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":908.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REMOVE JAW JOINT CARTILAGE","code_information":[{"code":"21060","type":"CPT"}],"standard_charges":[{"minimum":824.55,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1705.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":824.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":824.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":824.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REMOVE CORONOID PROCESS","code_information":[{"code":"21070","type":"CPT"}],"standard_charges":[{"minimum":643.92,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1331.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":643.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":643.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":643.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"MNPJ OF TMJ W/ANESTH","code_information":[{"code":"21073","type":"CPT"}],"standard_charges":[{"minimum":253.82,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":524.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.82,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.82,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21076","type":"CPT"}],"standard_charges":[{"minimum":741.27,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1532.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":741.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":741.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":741.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21077","type":"CPT"}],"standard_charges":[{"minimum":1824.68,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3773.33,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1824.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1824.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1824.68,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21079","type":"CPT"}],"standard_charges":[{"minimum":1225.47,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2533.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1225.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1225.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1225.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21080","type":"CPT"}],"standard_charges":[{"minimum":1391.68,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2877.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1391.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1391.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1391.68,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21081","type":"CPT"}],"standard_charges":[{"minimum":1273.78,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2633.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1273.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1273.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1273.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21082","type":"CPT"}],"standard_charges":[{"minimum":1164.9,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2408.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1164.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1164.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1164.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21083","type":"CPT"}],"standard_charges":[{"minimum":1080.89,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2234.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1080.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1080.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1080.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21084","type":"CPT"}],"standard_charges":[{"minimum":1250.71,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2585.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1250.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1250.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1250.71,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21085","type":"CPT"}],"standard_charges":[{"minimum":212.78,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1048.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":507.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":507.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":507.28,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":219.17,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":217.04,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21086","type":"CPT"}],"standard_charges":[{"minimum":1345.89,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2782.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21087","type":"CPT"}],"standard_charges":[{"minimum":1345.89,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2782.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21088","type":"CPT"}],"standard_charges":[{"minimum":1971.12,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2013,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2043.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2043.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2043.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"PREPARE FACE/ORAL PROSTHESIS","code_information":[{"code":"21089","type":"CPT"}],"standard_charges":[{"minimum":158.01,"maximum":1971.12,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":219.17,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":217.04,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"}]}]},{"description":"MAXILLOFACIAL FIXATION","code_information":[{"code":"21100","type":"CPT"}],"standard_charges":[{"minimum":372.08,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":769.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"INTERDENTAL FIXATION","code_information":[{"code":"21110","type":"CPT"}],"standard_charges":[{"minimum":753.16,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1557.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":753.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":753.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":753.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"INJECTION JAW JOINT X-RAY","code_information":[{"code":"21116","type":"CPT"}],"standard_charges":[{"minimum":46.87,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":289.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":289.82,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":289.82,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.87,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF CHIN","code_information":[{"code":"21120","type":"CPT"}],"standard_charges":[{"minimum":533.6,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1103.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":533.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":533.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":533.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF CHIN","code_information":[{"code":"21121","type":"CPT"}],"standard_charges":[{"minimum":556.67,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1151.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":556.67,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":556.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":556.67,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF CHIN","code_information":[{"code":"21122","type":"CPT"}],"standard_charges":[{"minimum":785.97,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1625.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":785.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":785.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":785.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF CHIN","code_information":[{"code":"21123","type":"CPT"}],"standard_charges":[{"minimum":891.25,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1842.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":891.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":891.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":891.25,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"AUGMENTATION LOWER JAW BONE","code_information":[{"code":"21125","type":"CPT"}],"standard_charges":[{"minimum":700.16,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1447.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":700.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":700.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":700.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"AUGMENTATION LOWER JAW BONE","code_information":[{"code":"21127","type":"CPT"}],"standard_charges":[{"minimum":802.92,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1660.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":802.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":802.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":802.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REDUCTION OF FOREHEAD","code_information":[{"code":"21137","type":"CPT"}],"standard_charges":[{"minimum":788.14,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1630.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":788.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":788.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":788.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"REDUCTION OF FOREHEAD","code_information":[{"code":"21138","type":"CPT"}],"standard_charges":[{"minimum":959.03,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1983.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":959.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":959.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":959.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REDUCTION OF FOREHEAD","code_information":[{"code":"21139","type":"CPT"}],"standard_charges":[{"minimum":1143.27,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2364.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1143.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1143.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1143.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"LEFORT I-1 PIECE W/O GRAFT","code_information":[{"code":"21141","type":"CPT"}],"standard_charges":[{"minimum":1399.61,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2894.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1399.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1399.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1399.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"LEFORT I-2 PIECE W/O GRAFT","code_information":[{"code":"21142","type":"CPT"}],"standard_charges":[{"minimum":1436.38,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2970.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1436.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1436.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1436.38,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"LEFORT I-3/> PIECE W/O GRAFT","code_information":[{"code":"21143","type":"CPT"}],"standard_charges":[{"minimum":1480.01,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3060.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1480.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1480.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1480.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"LEFORT I-1 PIECE W/ GRAFT","code_information":[{"code":"21145","type":"CPT"}],"standard_charges":[{"minimum":1627.47,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3365.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1627.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1627.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1627.47,"methodology":"fee schedule"}]}]},{"description":"LEFORT I-2 PIECE W/ GRAFT","code_information":[{"code":"21146","type":"CPT"}],"standard_charges":[{"minimum":1699.22,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3513.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1699.22,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1699.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1699.22,"methodology":"fee schedule"}]}]},{"description":"LEFORT I-3/> PIECE W/ GRAFT","code_information":[{"code":"21147","type":"CPT"}],"standard_charges":[{"minimum":1789.35,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3700.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1789.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1789.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1789.35,"methodology":"fee schedule"}]}]},{"description":"LEFORT II ANTERIOR INTRUSION","code_information":[{"code":"21150","type":"CPT"}],"standard_charges":[{"minimum":1728.06,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3573.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1728.06,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1728.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1728.06,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"LEFORT II W/BONE GRAFTS","code_information":[{"code":"21151","type":"CPT"}],"standard_charges":[{"minimum":1901.84,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3932.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1901.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1901.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1901.84,"methodology":"fee schedule"}]}]},{"description":"LEFORT III W/O LEFORT I","code_information":[{"code":"21154","type":"CPT"}],"standard_charges":[{"minimum":2046.41,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4231.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2046.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2046.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2046.41,"methodology":"fee schedule"}]}]},{"description":"LEFORT III W/ LEFORT I","code_information":[{"code":"21155","type":"CPT"}],"standard_charges":[{"minimum":2269.59,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4693.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2269.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2269.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2269.59,"methodology":"fee schedule"}]}]},{"description":"LEFORT III W/FHDW/O LEFORT I","code_information":[{"code":"21159","type":"CPT"}],"standard_charges":[{"minimum":2719.18,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5622.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2719.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2719.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2719.18,"methodology":"fee schedule"}]}]},{"description":"LEFORT III W/FHD W/ LEFORT I","code_information":[{"code":"21160","type":"CPT"}],"standard_charges":[{"minimum":2949.56,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":6098.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2949.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2949.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2949.56,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ORBIT/FOREHEAD","code_information":[{"code":"21172","type":"CPT"}],"standard_charges":[{"minimum":2212.26,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4574.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2212.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2212.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2212.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ORBIT/FOREHEAD","code_information":[{"code":"21175","type":"CPT"}],"standard_charges":[{"minimum":2312.85,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4782.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2312.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2312.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2312.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ENTIRE FOREHEAD","code_information":[{"code":"21179","type":"CPT"}],"standard_charges":[{"minimum":1591.41,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3290.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1591.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1591.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1591.41,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ENTIRE FOREHEAD","code_information":[{"code":"21180","type":"CPT"}],"standard_charges":[{"minimum":1777.09,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3674.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1777.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1777.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1777.09,"methodology":"fee schedule"}]}]},{"description":"CONTOUR CRANIAL BONE LESION","code_information":[{"code":"21181","type":"CPT"}],"standard_charges":[{"minimum":778.4,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1609.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":778.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":778.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":778.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT CRANIAL BONE","code_information":[{"code":"21182","type":"CPT"}],"standard_charges":[{"minimum":2211.9,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4573.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2211.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2211.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2211.9,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT CRANIAL BONE","code_information":[{"code":"21183","type":"CPT"}],"standard_charges":[{"minimum":2406.23,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4975.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2406.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2406.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2406.23,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT CRANIAL BONE","code_information":[{"code":"21184","type":"CPT"}],"standard_charges":[{"minimum":2587.22,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5349.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2587.22,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2587.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2587.22,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF MIDFACE","code_information":[{"code":"21188","type":"CPT"}],"standard_charges":[{"minimum":1660.28,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3433.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1660.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1660.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1660.28,"methodology":"fee schedule"}]}]},{"description":"RECONST LWR JAW W/O GRAFT","code_information":[{"code":"21193","type":"CPT"}],"standard_charges":[{"minimum":1293.25,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2674.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1293.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1293.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1293.25,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONST LWR JAW W/GRAFT","code_information":[{"code":"21194","type":"CPT"}],"standard_charges":[{"minimum":1495.87,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3093.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1495.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1495.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1495.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONST LWR JAW W/O FIXATION","code_information":[{"code":"21195","type":"CPT"}],"standard_charges":[{"minimum":1408.62,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2912.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1408.62,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1408.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1408.62,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONST LWR JAW W/FIXATION","code_information":[{"code":"21196","type":"CPT"}],"standard_charges":[{"minimum":1504.53,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3111.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1504.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1504.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1504.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTR LWR JAW SEGMENT","code_information":[{"code":"21198","type":"CPT"}],"standard_charges":[{"minimum":1074.4,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2221.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1074.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1074.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1074.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTR LWR JAW W/ADVANCE","code_information":[{"code":"21199","type":"CPT"}],"standard_charges":[{"minimum":1068.27,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2208.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1068.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1068.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1068.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES","code_information":[{"code":"212","type":"MS-DRG"}],"standard_charges":[{"minimum":100129.11,"maximum":212032,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":133501.29,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":100129.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":100129.11,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":152911.63,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":152911.63,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":157122.97,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":186581,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":154043,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":212032,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":109669.87,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":110766.57,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":112959.97,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":111863.27,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":109669.87,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":109669.87,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":109669.87,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":110766.57,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":109669.87,"methodology":"case rate"}]}]},{"description":"RECONSTRUCT UPPER JAW BONE","code_information":[{"code":"21206","type":"CPT"}],"standard_charges":[{"minimum":1020.32,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2109.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1020.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1020.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1020.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"AUGMENTATION OF FACIAL BONES","code_information":[{"code":"21208","type":"CPT"}],"standard_charges":[{"minimum":771.55,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1595.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":771.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":771.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":771.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REDUCTION OF FACIAL BONES","code_information":[{"code":"21209","type":"CPT"}],"standard_charges":[{"minimum":652.57,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1349.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":652.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":652.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":652.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"FACE BONE GRAFT","code_information":[{"code":"21210","type":"CPT"}],"standard_charges":[{"minimum":794.27,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1642.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":794.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"LOWER JAW BONE GRAFT","code_information":[{"code":"21215","type":"CPT"}],"standard_charges":[{"minimum":824.19,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1704.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":824.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":824.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":824.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RIB CARTILAGE GRAFT","code_information":[{"code":"21230","type":"CPT"}],"standard_charges":[{"minimum":786.69,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1626.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":786.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":786.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":786.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"EAR CARTILAGE GRAFT","code_information":[{"code":"21235","type":"CPT"}],"standard_charges":[{"minimum":598.49,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1237.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":598.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":598.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":598.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF JAW JOINT","code_information":[{"code":"21240","type":"CPT"}],"standard_charges":[{"minimum":1105.41,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2286,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1105.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1105.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1105.41,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF JAW JOINT","code_information":[{"code":"21242","type":"CPT"}],"standard_charges":[{"minimum":1062.87,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2197.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF JAW JOINT","code_information":[{"code":"21243","type":"CPT"}],"standard_charges":[{"minimum":1759.43,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3638.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1759.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1759.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1759.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF LOWER JAW","code_information":[{"code":"21244","type":"CPT"}],"standard_charges":[{"minimum":1059.26,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2190.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1059.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1059.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1059.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF JAW","code_information":[{"code":"21245","type":"CPT"}],"standard_charges":[{"minimum":996.17,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2059.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":996.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":996.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":996.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF JAW","code_information":[{"code":"21246","type":"CPT"}],"standard_charges":[{"minimum":892.33,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1845.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":892.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":892.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":892.33,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT LOWER JAW BONE","code_information":[{"code":"21247","type":"CPT"}],"standard_charges":[{"minimum":1658.84,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3430.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1658.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1658.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1658.84,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF JAW","code_information":[{"code":"21248","type":"CPT"}],"standard_charges":[{"minimum":829.96,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1716.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":829.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":829.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":829.96,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF JAW","code_information":[{"code":"21249","type":"CPT"}],"standard_charges":[{"minimum":1161.65,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2402.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1161.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1161.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1161.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT LOWER JAW BONE","code_information":[{"code":"21255","type":"CPT"}],"standard_charges":[{"minimum":1404.3,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2904.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1404.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1404.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1404.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF ORBIT","code_information":[{"code":"21256","type":"CPT"}],"standard_charges":[{"minimum":1298.3,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2684.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1298.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1298.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1298.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REVISE EYE SOCKETS","code_information":[{"code":"21260","type":"CPT"}],"standard_charges":[{"minimum":1434.94,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2966.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1434.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1434.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1434.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REVISE EYE SOCKETS","code_information":[{"code":"21261","type":"CPT"}],"standard_charges":[{"minimum":2539.99,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5252.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2539.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2539.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2539.99,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REVISE EYE SOCKETS","code_information":[{"code":"21263","type":"CPT"}],"standard_charges":[{"minimum":2349.63,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4858.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2349.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2349.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2349.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REVISE EYE SOCKETS","code_information":[{"code":"21267","type":"CPT"}],"standard_charges":[{"minimum":1678.3,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3470.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1678.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1678.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1678.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REVISE EYE SOCKETS","code_information":[{"code":"21268","type":"CPT"}],"standard_charges":[{"minimum":2104.46,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4351.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2104.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2104.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2104.46,"methodology":"fee schedule"}]}]},{"description":"AUGMENTATION CHEEK BONE","code_information":[{"code":"21270","type":"CPT"}],"standard_charges":[{"minimum":784.89,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1622.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REVISION ORBITOFACIAL BONES","code_information":[{"code":"21275","type":"CPT"}],"standard_charges":[{"minimum":885.12,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1830.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":885.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":885.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":885.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"REVISION OF EYELID","code_information":[{"code":"21280","type":"CPT"}],"standard_charges":[{"minimum":614,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1269.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":614,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":614,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":614,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"REVISION OF EYELID","code_information":[{"code":"21282","type":"CPT"}],"standard_charges":[{"minimum":417.14,"maximum":4367,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":862.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":417.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":417.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":417.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"REVISION OF JAW MUSCLE/BONE","code_information":[{"code":"21295","type":"CPT"}],"standard_charges":[{"minimum":206.95,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":428.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":206.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":206.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":206.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"REVISION OF JAW MUSCLE/BONE","code_information":[{"code":"21296","type":"CPT"}],"standard_charges":[{"minimum":430.12,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":889.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":430.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":430.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":430.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"CRANIO/MAXILLOFACIAL SURGERY","code_information":[{"code":"21299","type":"CPT"}],"standard_charges":[{"minimum":158.01,"maximum":3732.14,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":219.17,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":217.04,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"}]}]},{"description":"CLOSED TX NOSE FX W/O MANJ","code_information":[{"code":"21310","type":"CPT"}],"standard_charges":[{"minimum":61.12,"maximum":61.12,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":61.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"CLOSED TX NOSE FX W/O STABLJ","code_information":[{"code":"21315","type":"CPT"}],"standard_charges":[{"minimum":63.09,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":130.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"CLOSED TX NOSE FX W/ STABLJ","code_information":[{"code":"21320","type":"CPT"}],"standard_charges":[{"minimum":99.51,"maximum":3000.19,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":205.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"OPEN TX NOSE FX UNCOMPLICATD","code_information":[{"code":"21325","type":"CPT"}],"standard_charges":[{"minimum":469.42,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":970.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":469.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":469.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":469.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"OPEN TX NOSE FX W/SKELE FIXJ","code_information":[{"code":"21330","type":"CPT"}],"standard_charges":[{"minimum":564.6,"maximum":5630.87,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1167.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":564.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":564.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":564.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPEN TX NOSE  SEPTAL FX","code_information":[{"code":"21335","type":"CPT"}],"standard_charges":[{"minimum":754.25,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1559.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":754.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":754.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":754.25,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"OPEN TX SEPTAL FX W/WO STABJ","code_information":[{"code":"21336","type":"CPT"}],"standard_charges":[{"minimum":670.6,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1386.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":670.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":670.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":670.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"CLOSED TX SEPTALNOSE FX","code_information":[{"code":"21337","type":"CPT"}],"standard_charges":[{"minimum":316.91,"maximum":3000.19,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":654.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":316.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":316.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":316.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"OPEN NASOETHMOID FX W/O FIXJ","code_information":[{"code":"21338","type":"CPT"}],"standard_charges":[{"minimum":708.46,"maximum":5630.87,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1464.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":708.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":708.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":708.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPEN NASOETHMOID FX W/ FIXJ","code_information":[{"code":"21339","type":"CPT"}],"standard_charges":[{"minimum":801.12,"maximum":5630.87,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1656.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":801.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":801.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":801.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"PERQ TX NASOETHMOID FX","code_information":[{"code":"21340","type":"CPT"}],"standard_charges":[{"minimum":793.9,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1641.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":793.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":793.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":793.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"OPEN TX DPRSD FRONT SINUS FX","code_information":[{"code":"21343","type":"CPT"}],"standard_charges":[{"minimum":1146.87,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2371.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1146.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1146.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1146.87,"methodology":"fee schedule"}]}]},{"description":"OPEN TX COMPL FRONT SINUS FX","code_information":[{"code":"21344","type":"CPT"}],"standard_charges":[{"minimum":1469.55,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3038.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1469.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1469.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1469.55,"methodology":"fee schedule"}]}]},{"description":"CLOSED TX NOSE/JAW FX","code_information":[{"code":"21345","type":"CPT"}],"standard_charges":[{"minimum":674.93,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1395.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":674.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":674.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":674.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"OPN TX NASOMAX FX W/FIXJ","code_information":[{"code":"21346","type":"CPT"}],"standard_charges":[{"minimum":1080.89,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2234.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1080.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1080.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1080.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX NASOMAX FX MULTPLE","code_information":[{"code":"21347","type":"CPT"}],"standard_charges":[{"minimum":1096.4,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2266.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1096.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1096.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1096.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX NASOMAX FX W/GRAFT","code_information":[{"code":"21348","type":"CPT"}],"standard_charges":[{"minimum":1152.64,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2383.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1152.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1152.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1152.64,"methodology":"fee schedule"}]}]},{"description":"PERQ TX MALAR FRACTURE","code_information":[{"code":"21355","type":"CPT"}],"standard_charges":[{"minimum":347.56,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":718.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"OPN TX DPRSD ZYGOMATIC ARCH","code_information":[{"code":"21356","type":"CPT"}],"standard_charges":[{"minimum":423.99,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":876.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.99,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX DPRSD MALAR FRACTURE","code_information":[{"code":"21360","type":"CPT"}],"standard_charges":[{"minimum":553.43,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1144.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":553.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":553.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":553.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX COMPLX MALAR FX","code_information":[{"code":"21365","type":"CPT"}],"standard_charges":[{"minimum":1137.5,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2352.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1137.5,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1137.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1137.5,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX COMPLX MALAR W/GRFT","code_information":[{"code":"21366","type":"CPT"}],"standard_charges":[{"minimum":1336.87,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2764.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1336.87,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1336.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1336.87,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT FX TRANSANTRAL","code_information":[{"code":"21385","type":"CPT"}],"standard_charges":[{"minimum":769.75,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1592.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":769.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":769.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":769.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT FX PERIORBITAL","code_information":[{"code":"21386","type":"CPT"}],"standard_charges":[{"minimum":726.12,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1501.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":726.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":726.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":726.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT FX COMBINED","code_information":[{"code":"21387","type":"CPT"}],"standard_charges":[{"minimum":803.64,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1661.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":803.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":803.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":803.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT PERIORBTL IMPLT","code_information":[{"code":"21390","type":"CPT"}],"standard_charges":[{"minimum":843.3,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1744.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":843.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":843.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":843.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT PERIORBT W/GRFT","code_information":[{"code":"21395","type":"CPT"}],"standard_charges":[{"minimum":1057.46,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2186.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1057.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1057.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1057.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"CLOSED TX ORBIT W/O MANIPULJ","code_information":[{"code":"21400","type":"CPT"}],"standard_charges":[{"minimum":176.3,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":364.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":472.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":481.74,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":477.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":472.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"}]}]},{"description":"CLOSED TX ORBIT W/MANIPULJ","code_information":[{"code":"21401","type":"CPT"}],"standard_charges":[{"minimum":345.76,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":714.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT FX W/O IMPLANT","code_information":[{"code":"21406","type":"CPT"}],"standard_charges":[{"minimum":612.91,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1267.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":612.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":612.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":612.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT FX W/IMPLANT","code_information":[{"code":"21407","type":"CPT"}],"standard_charges":[{"minimum":679.25,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1404.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":679.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":679.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":679.25,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"OPN TX ORBIT FX W/BONE GRFT","code_information":[{"code":"21408","type":"CPT"}],"standard_charges":[{"minimum":947.13,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1958.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":947.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":947.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":947.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT MOUTH ROOF FRACTURE","code_information":[{"code":"21421","type":"CPT"}],"standard_charges":[{"minimum":572.17,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1183.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"TREAT MOUTH ROOF FRACTURE","code_information":[{"code":"21422","type":"CPT"}],"standard_charges":[{"minimum":661.59,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1367.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":661.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":661.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":661.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT MOUTH ROOF FRACTURE","code_information":[{"code":"21423","type":"CPT"}],"standard_charges":[{"minimum":837.53,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1732.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":837.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":837.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":837.53,"methodology":"fee schedule"}]}]},{"description":"TREAT CRANIOFACIAL FRACTURE","code_information":[{"code":"21431","type":"CPT"}],"standard_charges":[{"minimum":729.37,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1508.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":729.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":729.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":729.37,"methodology":"fee schedule"}]}]},{"description":"TREAT CRANIOFACIAL FRACTURE","code_information":[{"code":"21432","type":"CPT"}],"standard_charges":[{"minimum":752.08,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1555.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":752.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":752.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":752.08,"methodology":"fee schedule"}]}]},{"description":"TREAT CRANIOFACIAL FRACTURE","code_information":[{"code":"21433","type":"CPT"}],"standard_charges":[{"minimum":1814.23,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3751.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1814.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1814.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1814.23,"methodology":"fee schedule"}]}]},{"description":"TREAT CRANIOFACIAL FRACTURE","code_information":[{"code":"21435","type":"CPT"}],"standard_charges":[{"minimum":1473.88,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3047.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1473.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1473.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1473.88,"methodology":"fee schedule"}]}]},{"description":"TREAT CRANIOFACIAL FRACTURE","code_information":[{"code":"21436","type":"CPT"}],"standard_charges":[{"minimum":2130.78,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4406.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2130.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2130.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2130.78,"methodology":"fee schedule"}]}]},{"description":"TREAT DENTAL RIDGE FRACTURE","code_information":[{"code":"21440","type":"CPT"}],"standard_charges":[{"minimum":580.47,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":580.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":580.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":580.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"TREAT DENTAL RIDGE FRACTURE","code_information":[{"code":"21445","type":"CPT"}],"standard_charges":[{"minimum":669.16,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1384,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":669.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":669.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":669.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21450","type":"CPT"}],"standard_charges":[{"minimum":467.7,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1045.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":505.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":505.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":505.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":472.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":481.74,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":477.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":472.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":467.7,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21451","type":"CPT"}],"standard_charges":[{"minimum":675.65,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1396.85,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":675.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":675.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":675.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21452","type":"CPT"}],"standard_charges":[{"minimum":487.09,"maximum":5630.87,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1007.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":487.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":487.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":487.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21453","type":"CPT"}],"standard_charges":[{"minimum":978.86,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2024.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":978.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":978.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":978.86,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21454","type":"CPT"}],"standard_charges":[{"minimum":512.32,"maximum":5630.87,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1059.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":512.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":512.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":512.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21461","type":"CPT"}],"standard_charges":[{"minimum":1111.9,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2298.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21462","type":"CPT"}],"standard_charges":[{"minimum":1228.35,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2539.92,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1228.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1228.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1228.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21465","type":"CPT"}],"standard_charges":[{"minimum":836.45,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1729.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":836.45,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":836.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":836.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"TREAT LOWER JAW FRACTURE","code_information":[{"code":"21470","type":"CPT"}],"standard_charges":[{"minimum":1216.82,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2516.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1216.82,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1216.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1216.82,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"RESET DISLOCATED JAW","code_information":[{"code":"21480","type":"CPT"}],"standard_charges":[{"minimum":32.81,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":67.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.81,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"RESET DISLOCATED JAW","code_information":[{"code":"21485","type":"CPT"}],"standard_charges":[{"minimum":832.84,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1722.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":832.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":832.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":832.84,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"REPAIR DISLOCATED JAW","code_information":[{"code":"21490","type":"CPT"}],"standard_charges":[{"minimum":823.83,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1703.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":823.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":823.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":823.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3000.19,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2971.06,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2941.93,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2912.8,"methodology":"fee schedule"}]}]},{"description":"INTERDENTAL WIRING","code_information":[{"code":"21497","type":"CPT"}],"standard_charges":[{"minimum":619.76,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1281.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":619.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":619.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":619.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1463.85,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1449.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1435.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1421.21,"methodology":"fee schedule"}]}]},{"description":"HEAD SURGERY PROCEDURE","code_information":[{"code":"21499","type":"CPT"}],"standard_charges":[{"minimum":158.01,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":219.17,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":217.04,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"}]}]},{"description":"OTHER HEART ASSIST SYSTEM IMPLANT","code_information":[{"code":"215","type":"MS-DRG"}],"standard_charges":[{"minimum":105602.75,"maximum":274547.65,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":274547.65,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":205917.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":205917.19,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":145019.52,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":145019.52,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":149013.5,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176951,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":146092,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":201089,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":105602.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":106658.78,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":108770.84,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":107714.81,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":105602.75,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":105602.75,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":105602.75,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":106658.78,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":105602.75,"methodology":"case rate"}]}]},{"description":"DRAIN NECK/CHEST LESION","code_information":[{"code":"21501","type":"CPT"}],"standard_charges":[{"minimum":352.61,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":729.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"DRAIN CHEST LESION","code_information":[{"code":"21502","type":"CPT"}],"standard_charges":[{"minimum":530.71,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1097.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":530.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":530.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":530.71,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF BONE LESION","code_information":[{"code":"21510","type":"CPT"}],"standard_charges":[{"minimum":473.39,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":978.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":473.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":473.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":473.39,"methodology":"fee schedule"}]}]},{"description":"BX NECK/THORAX SOFT TISS","code_information":[{"code":"21550","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":3152.44,"maximum":4859.516,"gross_charge":5948,"discounted_cash":2379.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3152.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4859.52,"methodology":"fee schedule"}]}]},{"description":"BX NECK/THORAX SOFT TISS","code_information":[{"code":"21550","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":163.68,"maximum":4859.516,"gross_charge":5948,"discounted_cash":2379.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":3152.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":4859.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.68,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC NECK LES SC 3 CM/>","code_information":[{"code":"21552","type":"CPT"}],"standard_charges":[{"minimum":469.42,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":970.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":469.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":469.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":469.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC NECK TUM DEEP 5 CM/>","code_information":[{"code":"21554","type":"CPT"}],"standard_charges":[{"minimum":767.59,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1586.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":767.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":767.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":767.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC NECK LES SC < 3 CM","code_information":[{"code":"21555","type":"CPT"}],"standard_charges":[{"minimum":323.04,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":667.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":323.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":323.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":323.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC NECK TUM DEEP < 5 CM","code_information":[{"code":"21556","type":"CPT"}],"standard_charges":[{"minimum":558.83,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1155.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":558.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":558.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":558.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT NECK THORAX TUMOR<5CM","code_information":[{"code":"21557","type":"CPT"}],"standard_charges":[{"minimum":1000.13,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2067.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1000.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1000.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1000.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT NECK TUMOR 5 CM/>","code_information":[{"code":"21558","type":"CPT"}],"standard_charges":[{"minimum":1405.38,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2905.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1405.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1405.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1405.38,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC","code_information":[{"code":"216","type":"MS-DRG"}],"standard_charges":[{"minimum":101875.11,"maximum":191059,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180108.39,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":135085.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":135085.52,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137786.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":137786.14,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":141580.92,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":168125,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":138805,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":191059,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":101875.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":102893.87,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":104931.37,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":103912.62,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":101875.11,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":101875.11,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":101875.11,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":102893.87,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":101875.11,"methodology":"case rate"}]}]},{"description":"PARTIAL REMOVAL OF RIB","code_information":[{"code":"21600","type":"CPT"}],"standard_charges":[{"minimum":593.09,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1226.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":593.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":593.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":593.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"EXC CHEST WALL TUMOR W/RIBS","code_information":[{"code":"21601","type":"CPT"}],"standard_charges":[{"minimum":1189.78,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2460.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC CH WAL TUM W/O LYMPHADEC","code_information":[{"code":"21602","type":"CPT"}],"standard_charges":[{"minimum":1603.31,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3315.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1603.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1603.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1603.31,"methodology":"fee schedule"}]}]},{"description":"EXC CH WAL TUM W/LYMPHADEC","code_information":[{"code":"21603","type":"CPT"}],"standard_charges":[{"minimum":1747.89,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3614.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.89,"methodology":"fee schedule"}]}]},{"description":"PARTIAL REMOVAL OF RIB","code_information":[{"code":"21610","type":"CPT"}],"standard_charges":[{"minimum":1186.53,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2453.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1186.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1186.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1186.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF RIB","code_information":[{"code":"21615","type":"CPT"}],"standard_charges":[{"minimum":646.81,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":646.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":646.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":646.81,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF RIB AND NERVES","code_information":[{"code":"21616","type":"CPT"}],"standard_charges":[{"minimum":738.74,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1527.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":738.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":738.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":738.74,"methodology":"fee schedule"}]}]},{"description":"PARTIAL REMOVAL OF STERNUM","code_information":[{"code":"21620","type":"CPT"}],"standard_charges":[{"minimum":527.47,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1090.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":527.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":527.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":527.47,"methodology":"fee schedule"}]}]},{"description":"STERNAL DEBRIDEMENT","code_information":[{"code":"21627","type":"CPT"}],"standard_charges":[{"minimum":570.73,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1180.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":570.73,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":570.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":570.73,"methodology":"fee schedule"}]}]},{"description":"EXTENSIVE STERNUM SURGERY","code_information":[{"code":"21630","type":"CPT"}],"standard_charges":[{"minimum":1376.53,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2846.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1376.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1376.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1376.53,"methodology":"fee schedule"}]}]},{"description":"EXTENSIVE STERNUM SURGERY","code_information":[{"code":"21632","type":"CPT"}],"standard_charges":[{"minimum":1258.64,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2602.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1258.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1258.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1258.64,"methodology":"fee schedule"}]}]},{"description":"HYOID MYOTOMY  SUSPENSION","code_information":[{"code":"21685","type":"CPT"}],"standard_charges":[{"minimum":1035.47,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2141.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1035.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1035.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1035.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":5630.87,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":5576.2,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":5521.53,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":5466.86,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC","code_information":[{"code":"217","type":"MS-DRG"}],"standard_charges":[{"minimum":77438.75,"maximum":146756.99,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":146756.99,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":110071.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":110071.19,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":90368.16,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":90368.16,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":92857,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110266,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":91037,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":125307,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":77438.75,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":78213.14,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":79761.92,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":78987.53,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":77438.75,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":77438.75,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":77438.75,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":78213.14,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":77438.75,"methodology":"case rate"}]}]},{"description":"REVISION OF NECK MUSCLE","code_information":[{"code":"21700","type":"CPT"}],"standard_charges":[{"minimum":369.19,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":763.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REVISION OF NECK MUSCLE/RIB","code_information":[{"code":"21705","type":"CPT"}],"standard_charges":[{"minimum":550.9,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1139.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":550.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":550.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":550.9,"methodology":"fee schedule"}]}]},{"description":"REVISION OF NECK MUSCLE","code_information":[{"code":"21720","type":"CPT"}],"standard_charges":[{"minimum":558.47,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1155.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":558.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":558.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":558.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REVISION OF NECK MUSCLE","code_information":[{"code":"21725","type":"CPT"}],"standard_charges":[{"minimum":572.17,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1183.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":684.37,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":677.72,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":671.08,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":664.43,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCTION OF STERNUM","code_information":[{"code":"21740","type":"CPT"}],"standard_charges":[{"minimum":1062.14,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2196.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.14,"methodology":"fee schedule"}]}]},{"description":"REPAIR STERN/NUSS W/O SCOPE","code_information":[{"code":"21742","type":"CPT"}],"standard_charges":[{"minimum":1173.43,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2570.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1173.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1173.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1173.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REPAIR STERNUM/NUSS W/SCOPE","code_information":[{"code":"21743","type":"CPT"}],"standard_charges":[{"minimum":2113.6,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3431.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2113.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2113.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2113.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REPAIR OF STERNUM SEPARATION","code_information":[{"code":"21750","type":"CPT"}],"standard_charges":[{"minimum":702.33,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1452.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":702.33,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":702.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":702.33,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC","code_information":[{"code":"218","type":"MS-DRG"}],"standard_charges":[{"minimum":72547.08,"maximum":132786.67,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132786.67,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":99593.12,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":99593.12,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80876.05,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":80876.05,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":83103.46,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98684,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":81474,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":112145,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":72547.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":73272.56,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":74723.5,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":73998.03,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":72547.08,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":72547.08,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":72547.08,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":73272.56,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":72547.08,"methodology":"case rate"}]}]},{"description":"OPTX OF RIB FX W/FIXJ SCOPE","code_information":[{"code":"21811","type":"CPT"}],"standard_charges":[{"minimum":615.08,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1271.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":615.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":615.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":615.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREATMENT OF RIB FRACTURE","code_information":[{"code":"21812","type":"CPT"}],"standard_charges":[{"minimum":745.23,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1541.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":745.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":745.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":745.23,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREATMENT OF RIB FRACTURE","code_information":[{"code":"21813","type":"CPT"}],"standard_charges":[{"minimum":1017.8,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2104.41,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1017.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1017.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1017.8,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT STERNUM FRACTURE","code_information":[{"code":"21820","type":"CPT"}],"standard_charges":[{"minimum":157.56,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":326.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT STERNUM FRACTURE","code_information":[{"code":"21825","type":"CPT"}],"standard_charges":[{"minimum":575.42,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1189.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":575.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":575.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":575.42,"methodology":"fee schedule"}]}]},{"description":"NECK/CHEST SURGERY PROCEDURE","code_information":[{"code":"21899","type":"CPT"}],"standard_charges":[{"minimum":158.01,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.01,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":219.17,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":217.04,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.91,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":212.78,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC","code_information":[{"code":"219","type":"MS-DRG"}],"standard_charges":[{"minimum":87285.72,"maximum":155597.31,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155597.31,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":116701.64,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":116701.64,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109475.91,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":109475.91,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":112490.99,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":133581,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":110286,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":151803,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":87285.72,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":88158.58,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":89904.3,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":89031.44,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":87285.72,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":87285.72,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":87285.72,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":88158.58,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":87285.72,"methodology":"case rate"}]}]},{"description":"BIOPSY SOFT TISSUE OF BACK","code_information":[{"code":"21920","type":"CPT"}],"standard_charges":[{"minimum":162.24,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":335.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BX BACK/FLNK SFT TIS DEEP","code_information":[{"code":"21925","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":6834.88,"maximum":10536.032,"gross_charge":12896,"discounted_cash":5158.4,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":6834.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":10536.04,"methodology":"fee schedule"}]}]},{"description":"BX BACK/FLNK SFT TIS DEEP","code_information":[{"code":"21925","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":396.95,"maximum":10536.032,"gross_charge":12896,"discounted_cash":5158.4,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":6834.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":10536.04,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":396.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":396.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":396.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC BACK LES SC < 3 CM","code_information":[{"code":"21930","type":"CPT"}],"standard_charges":[{"minimum":382.89,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":791.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC BACK LES SC 3 CM/>","code_information":[{"code":"21931","type":"CPT"}],"standard_charges":[{"minimum":492.86,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1019.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":492.86,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":492.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":492.86,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC BACK TUM DEEP < 5 CM","code_information":[{"code":"21932","type":"CPT"}],"standard_charges":[{"minimum":698,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":698,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":698,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":698,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC BACK TUM DEEP 5 CM/>","code_information":[{"code":"21933","type":"CPT"}],"standard_charges":[{"minimum":774.08,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1600.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":774.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":774.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":774.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT BACK TUM < 5 CM","code_information":[{"code":"21935","type":"CPT"}],"standard_charges":[{"minimum":1066.83,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2205.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1066.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1066.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1066.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT BACK TUM 5 CM/>","code_information":[{"code":"21936","type":"CPT"}],"standard_charges":[{"minimum":1476.4,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3052.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1476.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1476.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1476.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC","code_information":[{"code":"220","type":"MS-DRG"}],"standard_charges":[{"minimum":69239.4,"maximum":119435.26,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":119435.26,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":89579.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":89579.25,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":74457.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":74457.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":76508.22,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":90852,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":75008,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":103245,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":69239.4,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":69931.8,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":71316.59,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":70624.19,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":69239.4,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":69239.4,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":69239.4,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":69931.8,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":69239.4,"methodology":"case rate"}]}]},{"description":"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2201","type":"APR-DRG"}],"standard_charges":[{"minimum":8457,"maximum":8457,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8457,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8457,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8457,"methodology":"case rate"}]}]},{"description":"ID P-SPINE C/T/CERV-THOR","code_information":[{"code":"22010","type":"CPT"}],"standard_charges":[{"minimum":1013.83,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2096.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1013.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1013.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1013.83,"methodology":"fee schedule"}]}]},{"description":"ID ABSCESS P-SPINE L/S/LS","code_information":[{"code":"22015","type":"CPT"}],"standard_charges":[{"minimum":997.25,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2062.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":997.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":997.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":997.25,"methodology":"fee schedule"}]}]},{"description":"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2202","type":"APR-DRG"}],"standard_charges":[{"minimum":12881,"maximum":12881,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12881,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12881,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12881,"methodology":"case rate"}]}]},{"description":"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2203","type":"APR-DRG"}],"standard_charges":[{"minimum":20066,"maximum":20066,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":20066,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":20066,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":20066,"methodology":"case rate"}]}]},{"description":"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2204","type":"APR-DRG"}],"standard_charges":[{"minimum":38032,"maximum":38032,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":38032,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":38032,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":38032,"methodology":"case rate"}]}]},{"description":"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC","code_information":[{"code":"221","type":"MS-DRG"}],"standard_charges":[{"minimum":64878.89,"maximum":113262.03,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":113262.03,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":84949.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":84949.19,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65996.17,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":65996.17,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":67813.78,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80528,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":66484,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":91512,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":64878.89,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":65527.68,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":66825.26,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":66176.47,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":64878.89,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":64878.89,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":64878.89,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":65527.68,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":64878.89,"methodology":"case rate"}]}]},{"description":"REMOVE PART OF NECK VERTEBRA","code_information":[{"code":"22100","type":"CPT"}],"standard_charges":[{"minimum":904.59,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1870.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":904.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":904.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":904.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE PART THORAX VERTEBRA","code_information":[{"code":"22101","type":"CPT"}],"standard_charges":[{"minimum":911.44,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1884.52,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":911.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":911.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":911.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE PART LUMBAR VERTEBRA","code_information":[{"code":"22102","type":"CPT"}],"standard_charges":[{"minimum":816.98,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1689.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":816.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":816.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":816.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE EXTRA SPINE SEGMENT","code_information":[{"code":"22103","type":"CPT"}],"standard_charges":[{"minimum":140.25,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1512.72,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":290.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":140.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":140.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":140.25,"methodology":"fee schedule"}]}]},{"description":"REMOVE PART OF NECK VERTEBRA","code_information":[{"code":"22110","type":"CPT"}],"standard_charges":[{"minimum":1111.9,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2299.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.9,"methodology":"fee schedule"}]}]},{"description":"REMOVE PART THORAX VERTEBRA","code_information":[{"code":"22112","type":"CPT"}],"standard_charges":[{"minimum":1189.78,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2460.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE PART LUMBAR VERTEBRA","code_information":[{"code":"22114","type":"CPT"}],"standard_charges":[{"minimum":1189.78,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2460.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1189.78,"methodology":"fee schedule"}]}]},{"description":"REMOVE EXTRA SPINE SEGMENT","code_information":[{"code":"22116","type":"CPT"}],"standard_charges":[{"minimum":146.02,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":301.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.02,"methodology":"fee schedule"}]}]},{"description":"CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC","code_information":[{"code":"222","type":"MS-DRG"}],"standard_charges":[{"minimum":86886.25,"maximum":89492.84,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":86886.25,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":87755.12,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":89492.84,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":88623.98,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":86886.25,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":86886.25,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":86886.25,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":87755.12,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":86886.25,"methodology":"case rate"}]}]},{"description":"INCIS SPINE 3 COLUMN THORAC","code_information":[{"code":"22206","type":"CPT"}],"standard_charges":[{"minimum":2551.17,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5275.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2551.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2551.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2551.17,"methodology":"fee schedule"}]}]},{"description":"INCIS SPINE 3 COLUMN LUMBAR","code_information":[{"code":"22207","type":"CPT"}],"standard_charges":[{"minimum":2502.13,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5173.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2502.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2502.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2502.13,"methodology":"fee schedule"}]}]},{"description":"INCIS SPINE 3 COLUMN ADL SEG","code_information":[{"code":"22208","type":"CPT"}],"standard_charges":[{"minimum":608.23,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1257.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.23,"methodology":"fee schedule"}]}]},{"description":"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2221","type":"APR-DRG"}],"standard_charges":[{"minimum":4815,"maximum":4815,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4815,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4815,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4815,"methodology":"case rate"}]}]},{"description":"INCIS 1 VERTEBRAL SEG CERV","code_information":[{"code":"22210","type":"CPT"}],"standard_charges":[{"minimum":1866.14,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3858.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1866.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1866.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1866.14,"methodology":"fee schedule"}]}]},{"description":"INCIS 1 VERTEBRAL SEG THORAC","code_information":[{"code":"22212","type":"CPT"}],"standard_charges":[{"minimum":1583.12,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3273.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1583.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1583.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1583.12,"methodology":"fee schedule"}]}]},{"description":"INCIS 1 VERTEBRAL SEG LUMBAR","code_information":[{"code":"22214","type":"CPT"}],"standard_charges":[{"minimum":1583.48,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3274.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1583.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1583.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1583.48,"methodology":"fee schedule"}]}]},{"description":"INCIS ADDL SPINE SEGMENT","code_information":[{"code":"22216","type":"CPT"}],"standard_charges":[{"minimum":375.68,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":776.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":375.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":375.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":375.68,"methodology":"fee schedule"}]}]},{"description":"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2222","type":"APR-DRG"}],"standard_charges":[{"minimum":7736,"maximum":7736,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7736,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7736,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7736,"methodology":"case rate"}]}]},{"description":"INCIS W/DISCECTOMY CERVICAL","code_information":[{"code":"22220","type":"CPT"}],"standard_charges":[{"minimum":1693.81,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3502.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1693.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1693.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1693.81,"methodology":"fee schedule"}]}]},{"description":"INCIS W/DISCECTOMY THORACIC","code_information":[{"code":"22222","type":"CPT"}],"standard_charges":[{"minimum":1841.27,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3807.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1841.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1841.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1841.27,"methodology":"fee schedule"}]}]},{"description":"INCIS W/DISCECTOMY LUMBAR","code_information":[{"code":"22224","type":"CPT"}],"standard_charges":[{"minimum":1657.03,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3426.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1657.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1657.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1657.03,"methodology":"fee schedule"}]}]},{"description":"REVISE EXTRA SPINE SEGMENT","code_information":[{"code":"22226","type":"CPT"}],"standard_charges":[{"minimum":371.71,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":768.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":371.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":371.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":371.71,"methodology":"fee schedule"}]}]},{"description":"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2223","type":"APR-DRG"}],"standard_charges":[{"minimum":12914,"maximum":12914,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12914,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12914,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12914,"methodology":"case rate"}]}]},{"description":"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2224","type":"APR-DRG"}],"standard_charges":[{"minimum":26122,"maximum":26122,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":26122,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":26122,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":26122,"methodology":"case rate"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2231","type":"APR-DRG"}],"standard_charges":[{"minimum":6388,"maximum":6388,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6388,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6388,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6388,"methodology":"case rate"}]}]},{"description":"CLOSED TX VERT FX W/O MANJ","code_information":[{"code":"22310","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1551.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1551.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1551.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":648.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":313.67,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":313.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":313.67,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"CLOSED TX VERT FX W/MANJ","code_information":[{"code":"22315","type":"CPT"}],"standard_charges":[{"minimum":811.93,"maximum":3138.99,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1678.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":811.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":811.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":811.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"TREAT ODONTOID FX W/O GRAFT","code_information":[{"code":"22318","type":"CPT"}],"standard_charges":[{"minimum":1726.98,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3570.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1726.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1726.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1726.98,"methodology":"fee schedule"}]}]},{"description":"TREAT ODONTOID FX W/GRAFT","code_information":[{"code":"22319","type":"CPT"}],"standard_charges":[{"minimum":1915.18,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3960.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1915.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1915.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1915.18,"methodology":"fee schedule"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2232","type":"APR-DRG"}],"standard_charges":[{"minimum":9244,"maximum":9244,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9244,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9244,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9244,"methodology":"case rate"}]}]},{"description":"TREAT SPINE FRACTURE","code_information":[{"code":"22325","type":"CPT"}],"standard_charges":[{"minimum":1544.18,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3193.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1544.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1544.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1544.18,"methodology":"fee schedule"}]}]},{"description":"TREAT NECK SPINE FRACTURE","code_information":[{"code":"22326","type":"CPT"}],"standard_charges":[{"minimum":1581.68,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3270.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1581.68,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1581.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1581.68,"methodology":"fee schedule"}]}]},{"description":"TREAT THORAX SPINE FRACTURE","code_information":[{"code":"22327","type":"CPT"}],"standard_charges":[{"minimum":1608.72,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3326.64,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1608.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1608.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1608.72,"methodology":"fee schedule"}]}]},{"description":"TREAT EACH ADD SPINE FX","code_information":[{"code":"22328","type":"CPT"}],"standard_charges":[{"minimum":292.76,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":605.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":292.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":292.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":292.76,"methodology":"fee schedule"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2233","type":"APR-DRG"}],"standard_charges":[{"minimum":13860,"maximum":13860,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13860,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13860,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13860,"methodology":"case rate"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2234","type":"APR-DRG"}],"standard_charges":[{"minimum":25974,"maximum":25974,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25974,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25974,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25974,"methodology":"case rate"}]}]},{"description":"CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC","code_information":[{"code":"224","type":"MS-DRG"}],"standard_charges":[{"minimum":82735,"maximum":85217.05,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":82735,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":83562.35,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":85217.05,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":84389.7,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":82735,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":82735,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":82735,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":83562.35,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":82735,"methodology":"case rate"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2241","type":"APR-DRG"}],"standard_charges":[{"minimum":7345,"maximum":7345,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7345,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7345,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7345,"methodology":"case rate"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2242","type":"APR-DRG"}],"standard_charges":[{"minimum":9576,"maximum":9576,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9576,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9576,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9576,"methodology":"case rate"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2243","type":"APR-DRG"}],"standard_charges":[{"minimum":13788,"maximum":13788,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13788,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13788,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13788,"methodology":"case rate"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2244","type":"APR-DRG"}],"standard_charges":[{"minimum":25325,"maximum":25325,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25325,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25325,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25325,"methodology":"case rate"}]}]},{"description":"MANIPULATION OF SPINE","code_information":[{"code":"22505","type":"CPT"}],"standard_charges":[{"minimum":136.28,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":281.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.28,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"PERQ CERVICOTHORACIC INJECT","code_information":[{"code":"22510","type":"CPT"}],"standard_charges":[{"minimum":451.39,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":933.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":451.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":451.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":451.39,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"PERQ LUMBOSACRAL INJECTION","code_information":[{"code":"22511","type":"CPT"}],"standard_charges":[{"minimum":423.63,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":875.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"VERTEBROPLASTY ADDL INJECT","code_information":[{"code":"22512","type":"CPT"}],"standard_charges":[{"minimum":214.88,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":444.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.88,"methodology":"fee schedule"}]}]},{"description":"PERQ VERTEBRAL AUGMENTATION","code_information":[{"code":"22513","type":"CPT"}],"standard_charges":[{"minimum":531.43,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1098.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"PERQ VERTEBRAL AUGMENTATION","code_information":[{"code":"22514","type":"CPT"}],"standard_charges":[{"minimum":495.38,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1024.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":495.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":495.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":495.38,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"PERQ VERTEBRAL AUGMENTATION","code_information":[{"code":"22515","type":"CPT"}],"standard_charges":[{"minimum":226.42,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":468.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.42,"methodology":"fee schedule"}]}]},{"description":"IDET SINGLE LEVEL","code_information":[{"code":"22526","type":"CPT"}],"standard_charges":[{"minimum":708.58,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":708.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"IDET 1 OR MORE LEVELS","code_information":[{"code":"22527","type":"CPT"}],"standard_charges":[{"minimum":328.28,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":985.56,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":328.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"LAT THORAX SPINE FUSION","code_information":[{"code":"22532","type":"CPT"}],"standard_charges":[{"minimum":1877.32,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3881.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1877.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1877.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1877.32,"methodology":"fee schedule"}]}]},{"description":"LAT LUMBAR SPINE FUSION","code_information":[{"code":"22533","type":"CPT"}],"standard_charges":[{"minimum":1730.58,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3578.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1730.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1730.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1730.58,"methodology":"fee schedule"}]}]},{"description":"LAT THOR/LUMB ADDL SEG","code_information":[{"code":"22534","type":"CPT"}],"standard_charges":[{"minimum":373.16,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":771.43,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.16,"methodology":"fee schedule"}]}]},{"description":"NECK SPINE FUSION","code_information":[{"code":"22548","type":"CPT"}],"standard_charges":[{"minimum":2052.9,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4245.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2052.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2052.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2052.9,"methodology":"fee schedule"}]}]},{"description":"NECK SPINE FUSEREMOV BEL C2","code_information":[{"code":"22551","type":"CPT"}],"standard_charges":[{"minimum":1777.09,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3674.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1777.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1777.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1777.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"ADDL NECK SPINE FUSION","code_information":[{"code":"22552","type":"CPT"}],"standard_charges":[{"minimum":410.29,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":848.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":410.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":410.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":410.29,"methodology":"fee schedule"}]}]},{"description":"NECK SPINE FUSION","code_information":[{"code":"22554","type":"CPT"}],"standard_charges":[{"minimum":1320.29,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2729.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1320.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1320.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1320.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"THORAX SPINE FUSION","code_information":[{"code":"22556","type":"CPT"}],"standard_charges":[{"minimum":1747.17,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3612.42,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.17,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE FUSION","code_information":[{"code":"22558","type":"CPT"}],"standard_charges":[{"minimum":1595.38,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3299.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1595.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1595.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1595.38,"methodology":"fee schedule"}]}]},{"description":"ADDITIONAL SPINAL FUSION","code_information":[{"code":"22585","type":"CPT"}],"standard_charges":[{"minimum":337.1,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":697.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.1,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.1,"methodology":"fee schedule"}]}]},{"description":"PRESCRL FUSE W/ INSTR L5-S1","code_information":[{"code":"22586","type":"CPT"}],"standard_charges":[{"minimum":4390.54,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4390.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"SPINE  SKULL SPINAL FUSION","code_information":[{"code":"22590","type":"CPT"}],"standard_charges":[{"minimum":1662.8,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3438.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1662.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1662.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1662.8,"methodology":"fee schedule"}]}]},{"description":"NECK SPINAL FUSION","code_information":[{"code":"22595","type":"CPT"}],"standard_charges":[{"minimum":1586.37,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3280.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1586.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1586.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1586.37,"methodology":"fee schedule"}]}]},{"description":"CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC","code_information":[{"code":"226","type":"MS-DRG"}],"standard_charges":[{"minimum":77699.2,"maximum":80030.18,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":77699.2,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":78476.2,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":80030.18,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":79253.19,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":77699.2,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":77699.2,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":77699.2,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":78476.2,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":77699.2,"methodology":"case rate"}]}]},{"description":"NECK SPINE FUSION","code_information":[{"code":"22600","type":"CPT"}],"standard_charges":[{"minimum":1363.55,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2819.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1363.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1363.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1363.55,"methodology":"fee schedule"}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2261","type":"APR-DRG"}],"standard_charges":[{"minimum":5419,"maximum":5419,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5419,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5419,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5419,"methodology":"case rate"}]}]},{"description":"THORAX SPINE FUSION","code_information":[{"code":"22610","type":"CPT"}],"standard_charges":[{"minimum":1341.2,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2773.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1341.2,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1341.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1341.2,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE FUSION","code_information":[{"code":"22612","type":"CPT"}],"standard_charges":[{"minimum":1655.59,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3423.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1655.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1655.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1655.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"SPINE FUSION EXTRA SEGMENT","code_information":[{"code":"22614","type":"CPT"}],"standard_charges":[{"minimum":404.88,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":837.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":404.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":404.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":404.88,"methodology":"fee schedule"}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2262","type":"APR-DRG"}],"standard_charges":[{"minimum":7446,"maximum":7446,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7446,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7446,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7446,"methodology":"case rate"}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2263","type":"APR-DRG"}],"standard_charges":[{"minimum":10828,"maximum":10828,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10828,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10828,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10828,"methodology":"case rate"}]}]},{"description":"LUMBAR SPINE FUSION","code_information":[{"code":"22630","type":"CPT"}],"standard_charges":[{"minimum":1628.55,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3367.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1628.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1628.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1628.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"SPINE FUSION EXTRA SEGMENT","code_information":[{"code":"22632","type":"CPT"}],"standard_charges":[{"minimum":332.06,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":686.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":332.06,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":332.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":332.06,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE FUSION COMBINED","code_information":[{"code":"22633","type":"CPT"}],"standard_charges":[{"minimum":1888.14,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3904.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1888.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1888.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1888.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"SPINE FUSION EXTRA SEGMENT","code_information":[{"code":"22634","type":"CPT"}],"standard_charges":[{"minimum":501.51,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1037.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":501.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":501.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":501.51,"methodology":"fee schedule"}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2264","type":"APR-DRG"}],"standard_charges":[{"minimum":25399,"maximum":25399,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25399,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25399,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25399,"methodology":"case rate"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL","code_information":[{"code":"2271","type":"APR-DRG"}],"standard_charges":[{"minimum":7150,"maximum":7150,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7150,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7150,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7150,"methodology":"case rate"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL","code_information":[{"code":"2272","type":"APR-DRG"}],"standard_charges":[{"minimum":9032,"maximum":9032,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9032,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9032,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9032,"methodology":"case rate"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL","code_information":[{"code":"2273","type":"APR-DRG"}],"standard_charges":[{"minimum":13973,"maximum":13973,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13973,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13973,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13973,"methodology":"case rate"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL","code_information":[{"code":"2274","type":"APR-DRG"}],"standard_charges":[{"minimum":24857,"maximum":24857,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":24857,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":24857,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":24857,"methodology":"case rate"}]}]},{"description":"OTHER CARDIOTHORACIC PROCEDURES WITH MCC","code_information":[{"code":"228","type":"MS-DRG"}],"standard_charges":[{"minimum":67732.97,"maximum":139601.15,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":139601.15,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":104704.14,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":104704.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":71534.42,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":71534.42,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":73504.56,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87285,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":72063,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":99192,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":67732.97,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":68410.3,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":69764.96,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":69087.63,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":67732.97,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":67732.97,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":67732.97,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":68410.3,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":67732.97,"methodology":"case rate"}]}]},{"description":"POST FUSION </6 VERT SEG","code_information":[{"code":"22800","type":"CPT"}],"standard_charges":[{"minimum":1431.34,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2959.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1431.34,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1431.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1431.34,"methodology":"fee schedule"}]}]},{"description":"POST FUSION 7-12 VERT SEG","code_information":[{"code":"22802","type":"CPT"}],"standard_charges":[{"minimum":2211.18,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4572.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2211.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2211.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2211.18,"methodology":"fee schedule"}]}]},{"description":"POST FUSION 13/> VERT SEG","code_information":[{"code":"22804","type":"CPT"}],"standard_charges":[{"minimum":2539.27,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5250.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2539.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2539.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2539.27,"methodology":"fee schedule"}]}]},{"description":"ANT FUSION 2-3 VERT SEG","code_information":[{"code":"22808","type":"CPT"}],"standard_charges":[{"minimum":1905.44,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3939.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1905.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1905.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1905.44,"methodology":"fee schedule"}]}]},{"description":"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2281","type":"APR-DRG"}],"standard_charges":[{"minimum":5567,"maximum":5567,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5567,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5567,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5567,"methodology":"case rate"}]}]},{"description":"ANT FUSION 4-7 VERT SEG","code_information":[{"code":"22810","type":"CPT"}],"standard_charges":[{"minimum":2096.89,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4335.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2096.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2096.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2096.89,"methodology":"fee schedule"}]}]},{"description":"ANT FUSION 8/> VERT SEG","code_information":[{"code":"22812","type":"CPT"}],"standard_charges":[{"minimum":2297.71,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4750.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2297.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2297.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2297.71,"methodology":"fee schedule"}]}]},{"description":"KYPHECTOMY 1-2 SEGMENTS","code_information":[{"code":"22818","type":"CPT"}],"standard_charges":[{"minimum":2243.27,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4638.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2243.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2243.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2243.27,"methodology":"fee schedule"}]}]},{"description":"KYPHECTOMY 3 OR MORE","code_information":[{"code":"22819","type":"CPT"}],"standard_charges":[{"minimum":2583.25,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5341.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2583.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2583.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2583.25,"methodology":"fee schedule"}]}]},{"description":"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2282","type":"APR-DRG"}],"standard_charges":[{"minimum":7158,"maximum":7158,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7158,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7158,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7158,"methodology":"case rate"}]}]},{"description":"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2283","type":"APR-DRG"}],"standard_charges":[{"minimum":10699,"maximum":10699,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10699,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10699,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10699,"methodology":"case rate"}]}]},{"description":"EXPLORATION OF SPINAL FUSION","code_information":[{"code":"22830","type":"CPT"}],"standard_charges":[{"minimum":862.05,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1782.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":862.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":862.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":862.05,"methodology":"fee schedule"}]}]},{"description":"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2284","type":"APR-DRG"}],"standard_charges":[{"minimum":20335,"maximum":20335,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":20335,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":20335,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":20335,"methodology":"case rate"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22840","type":"CPT"}],"standard_charges":[{"minimum":784.89,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1623.05,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.89,"methodology":"fee schedule"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22841","type":"CPT"}],"standard_charges":[{"minimum":844.21,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":844.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_percentage":14,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22842","type":"CPT"}],"standard_charges":[{"minimum":790.3,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1634.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":790.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":790.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":790.3,"methodology":"fee schedule"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22843","type":"CPT"}],"standard_charges":[{"minimum":846.18,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1749.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":846.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":846.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":846.18,"methodology":"fee schedule"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22844","type":"CPT"}],"standard_charges":[{"minimum":1021.4,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2111.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1021.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1021.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1021.4,"methodology":"fee schedule"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22845","type":"CPT"}],"standard_charges":[{"minimum":752.44,"maximum":8982,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1556.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":8982,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":752.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":752.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":752.44,"methodology":"fee schedule"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22846","type":"CPT"}],"standard_charges":[{"minimum":783.09,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1619.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.09,"methodology":"fee schedule"}]}]},{"description":"INSERT SPINE FIXATION DEVICE","code_information":[{"code":"22847","type":"CPT"}],"standard_charges":[{"minimum":830.32,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1717.21,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":830.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":830.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":830.32,"methodology":"fee schedule"}]}]},{"description":"INSERT PELV FIXATION DEVICE","code_information":[{"code":"22848","type":"CPT"}],"standard_charges":[{"minimum":372.44,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":770.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.44,"methodology":"fee schedule"}]}]},{"description":"REINSERT SPINAL FIXATION","code_information":[{"code":"22849","type":"CPT"}],"standard_charges":[{"minimum":1365.72,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2824.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1365.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1365.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1365.72,"methodology":"fee schedule"}]}]},{"description":"REMOVE SPINE FIXATION DEVICE","code_information":[{"code":"22850","type":"CPT"}],"standard_charges":[{"minimum":771.19,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1594.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":771.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":771.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":771.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE SPINE FIXATION DEVICE","code_information":[{"code":"22852","type":"CPT"}],"standard_charges":[{"minimum":742.35,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1535.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":742.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":742.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":742.35,"methodology":"fee schedule"}]}]},{"description":"INSJ BIOMECHANICAL DEVICE","code_information":[{"code":"22853","type":"CPT"}],"standard_charges":[{"minimum":267.16,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":552.55,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":267.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":267.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":267.16,"methodology":"fee schedule"}]}]},{"description":"INSJ BIOMECHANICAL DEVICE","code_information":[{"code":"22854","type":"CPT"}],"standard_charges":[{"minimum":347.2,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":718.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.2,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.2,"methodology":"fee schedule"}]}]},{"description":"REMOVE SPINE FIXATION DEVICE","code_information":[{"code":"22855","type":"CPT"}],"standard_charges":[{"minimum":1160.57,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2399.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1160.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1160.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1160.57,"methodology":"fee schedule"}]}]},{"description":"CERV ARTIFIC DISKECTOMY","code_information":[{"code":"22856","type":"CPT"}],"standard_charges":[{"minimum":1696.69,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3508.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1696.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1696.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1696.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"LUMBAR ARTIF DISKECTOMY","code_information":[{"code":"22857","type":"CPT"}],"standard_charges":[{"minimum":1845.59,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3816.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1845.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1845.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1845.59,"methodology":"fee schedule"}]}]},{"description":"SECOND LEVEL CER DISKECTOMY","code_information":[{"code":"22858","type":"CPT"}],"standard_charges":[{"minimum":524.58,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1084.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.58,"methodology":"fee schedule"}]}]},{"description":"INSJ BIOMECHANICAL DEVICE","code_information":[{"code":"22859","type":"CPT"}],"standard_charges":[{"minimum":345.03,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":713.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.03,"methodology":"fee schedule"}]}]},{"description":"NO ACTIVE CODE DESCRIPTION","code_information":[{"code":"22860","type":"CPT"}],"standard_charges":[{"minimum":3965.16,"maximum":3965.16,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3965.16,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"}]}]},{"description":"REVISE CERV ARTIFIC DISC","code_information":[{"code":"22861","type":"CPT"}],"standard_charges":[{"minimum":2418.13,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5000.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2418.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2418.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2418.13,"methodology":"fee schedule"}]}]},{"description":"REVISE LUMBAR ARTIF DISC","code_information":[{"code":"22862","type":"CPT"}],"standard_charges":[{"minimum":2418.49,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":5000.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2418.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2418.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2418.49,"methodology":"fee schedule"}]}]},{"description":"REMOVE CERV ARTIF DISC","code_information":[{"code":"22864","type":"CPT"}],"standard_charges":[{"minimum":2159.26,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4465.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2159.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2159.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2159.26,"methodology":"fee schedule"}]}]},{"description":"REMOVE LUMB ARTIF DISC","code_information":[{"code":"22865","type":"CPT"}],"standard_charges":[{"minimum":2360.44,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4924,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4881.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2360.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2360.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2360.44,"methodology":"fee schedule"}]}]},{"description":"INSJ STABLJ DEV W/DCMPRN","code_information":[{"code":"22867","type":"CPT"}],"standard_charges":[{"minimum":1125.96,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2327.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1125.96,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1125.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1125.96,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"INSJ STABLJ DEV W/DCMPRN","code_information":[{"code":"22868","type":"CPT"}],"standard_charges":[{"minimum":252.38,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":521.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.38,"methodology":"fee schedule"}]}]},{"description":"INSJ STABLJ DEV W/O DCMPRN","code_information":[{"code":"22869","type":"CPT"}],"standard_charges":[{"minimum":452.84,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":936.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":452.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":452.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":452.84,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"INSJ STABLJ DEV W/O DCMPRN","code_information":[{"code":"22870","type":"CPT"}],"standard_charges":[{"minimum":123.3,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":255.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.3,"methodology":"fee schedule"}]}]},{"description":"SPINE SURGERY PROCEDURE","code_information":[{"code":"22899","type":"CPT"}],"standard_charges":[{"minimum":153.97,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC","code_information":[{"code":"229","type":"MS-DRG"}],"standard_charges":[{"minimum":45140.78,"maximum":110170.63,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110170.63,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":82630.56,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":82630.56,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45140.78,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":45140.78,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":46384,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55080,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":45475,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":62594,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":54131.29,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":54672.61,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":55755.23,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":55213.92,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":54131.29,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":54131.29,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":54131.29,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":54672.61,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":54131.29,"methodology":"case rate"}]}]},{"description":"EXC ABDL TUM DEEP < 5 CM","code_information":[{"code":"22900","type":"CPT"}],"standard_charges":[{"minimum":593.45,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1227.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":593.45,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":593.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":593.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC ABDL TUM DEEP 5 CM/>","code_information":[{"code":"22901","type":"CPT"}],"standard_charges":[{"minimum":698,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":698,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":698,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":698,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC ABD LES SC < 3 CM","code_information":[{"code":"22902","type":"CPT"}],"standard_charges":[{"minimum":350.08,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":724.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":350.08,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":350.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":350.08,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC ABD LES SC 3 CM/>","code_information":[{"code":"22903","type":"CPT"}],"standard_charges":[{"minimum":462.21,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":955.86,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":462.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":462.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":462.21,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RADICAL RESECT ABD TUMOR<5CM","code_information":[{"code":"22904","type":"CPT"}],"standard_charges":[{"minimum":1097.48,"maximum":5144,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2269.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1097.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1097.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1097.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RAD RESECT ABD TUMOR 5 CM/>","code_information":[{"code":"22905","type":"CPT"}],"standard_charges":[{"minimum":1385.55,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2865.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1385.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1385.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1385.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2291","type":"APR-DRG"}],"standard_charges":[{"minimum":7049,"maximum":7049,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7049,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7049,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7049,"methodology":"case rate"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2292","type":"APR-DRG"}],"standard_charges":[{"minimum":9102,"maximum":9102,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":9102,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":9102,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":9102,"methodology":"case rate"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2293","type":"APR-DRG"}],"standard_charges":[{"minimum":13233,"maximum":13233,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13233,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13233,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13233,"methodology":"case rate"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2294","type":"APR-DRG"}],"standard_charges":[{"minimum":25842,"maximum":25842,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":25842,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":25842,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":25842,"methodology":"case rate"}]}]},{"description":"ABDOMEN SURGERY PROCEDURE","code_information":[{"code":"22999","type":"CPT"}],"standard_charges":[{"minimum":153.97,"maximum":3021.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF CALCIUM DEPOSITS","code_information":[{"code":"23000","type":"CPT"}],"standard_charges":[{"minimum":376.04,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":777.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":376.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":376.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":376.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2301","type":"APR-DRG"}],"standard_charges":[{"minimum":8302,"maximum":8302,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8302,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8302,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8302,"methodology":"case rate"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2302","type":"APR-DRG"}],"standard_charges":[{"minimum":11513,"maximum":11513,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11513,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11513,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11513,"methodology":"case rate"}]}]},{"description":"RELEASE SHOULDER JOINT","code_information":[{"code":"23020","type":"CPT"}],"standard_charges":[{"minimum":728.65,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1506.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":728.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":728.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":728.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2303","type":"APR-DRG"}],"standard_charges":[{"minimum":17014,"maximum":17014,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":17014,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":17014,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":17014,"methodology":"case rate"}]}]},{"description":"DRAIN SHOULDER LESION","code_information":[{"code":"23030","type":"CPT"}],"standard_charges":[{"minimum":267.52,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":553.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":267.52,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":267.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":267.52,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"DRAIN SHOULDER BURSA","code_information":[{"code":"23031","type":"CPT"}],"standard_charges":[{"minimum":233.99,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":483.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":233.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":233.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":233.99,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"DRAIN SHOULDER BONE LESION","code_information":[{"code":"23035","type":"CPT"}],"standard_charges":[{"minimum":719.63,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1487.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":719.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":719.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":719.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2304","type":"APR-DRG"}],"standard_charges":[{"minimum":32821,"maximum":32821,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":32821,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":32821,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":32821,"methodology":"case rate"}]}]},{"description":"EXPLORATORY SHOULDER SURGERY","code_information":[{"code":"23040","type":"CPT"}],"standard_charges":[{"minimum":757.13,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1565.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":757.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":757.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":757.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"EXPLORATORY SHOULDER SURGERY","code_information":[{"code":"23044","type":"CPT"}],"standard_charges":[{"minimum":600.66,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1241.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":600.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":600.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":600.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"BIOPSY SHOULDER TISSUES","code_information":[{"code":"23065","type":"CPT"}],"standard_charges":[{"minimum":167.29,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":346.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":167.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":167.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":167.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BIOPSY SHOULDER TISSUES","code_information":[{"code":"23066","type":"CPT"}],"standard_charges":[{"minimum":385.78,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":797.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":385.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC SHOULDER LES SC 3 CM/>","code_information":[{"code":"23071","type":"CPT"}],"standard_charges":[{"minimum":441.3,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":912.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":441.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":441.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":441.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC SHOULDER TUM DEEP 5 CM/>","code_information":[{"code":"23073","type":"CPT"}],"standard_charges":[{"minimum":731.89,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1513.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":731.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":731.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":731.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC SHOULDER LES SC < 3 CM","code_information":[{"code":"23075","type":"CPT"}],"standard_charges":[{"minimum":345.4,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":714.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":345.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EXC SHOULDER TUM DEEP < 5 CM","code_information":[{"code":"23076","type":"CPT"}],"standard_charges":[{"minimum":572.17,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1182.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":572.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT SHOULDER TUMOR < 5 CM","code_information":[{"code":"23077","type":"CPT"}],"standard_charges":[{"minimum":1180.04,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2439.76,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1180.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1180.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1180.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT SHOULDER TUMOR 5 CM/>","code_information":[{"code":"23078","type":"CPT"}],"standard_charges":[{"minimum":1498.04,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3097.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1498.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1498.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1498.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITH PTCA WITH MCC","code_information":[{"code":"231","type":"MS-DRG"}],"standard_charges":[{"minimum":90241.5,"maximum":159756,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155039.01,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":116282.9,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":116282.9,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":115211.49,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":115211.49,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":118384.54,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":140580,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":116064,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":159756,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":90241.5,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":91143.92,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":92948.75,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":92046.33,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":90241.5,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":90241.5,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":90241.5,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":91143.92,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":90241.5,"methodology":"case rate"}]}]},{"description":"BIOPSY OF SHOULDER JOINT","code_information":[{"code":"23100","type":"CPT"}],"standard_charges":[{"minimum":536.84,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1109.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":536.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":536.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":536.84,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"SHOULDER JOINT SURGERY","code_information":[{"code":"23101","type":"CPT"}],"standard_charges":[{"minimum":484.56,"maximum":5890.44,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1001.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":484.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":484.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":484.56,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE SHOULDER JOINT LINING","code_information":[{"code":"23105","type":"CPT"}],"standard_charges":[{"minimum":675.29,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1396.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":675.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":675.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":675.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"INCISION OF COLLARBONE JOINT","code_information":[{"code":"23106","type":"CPT"}],"standard_charges":[{"minimum":532.51,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1101.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":532.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":532.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":532.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"EXPLORE TREAT SHOULDER JOINT","code_information":[{"code":"23107","type":"CPT"}],"standard_charges":[{"minimum":698.72,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1444.89,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":698.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":698.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":698.72,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2311","type":"APR-DRG"}],"standard_charges":[{"minimum":8593,"maximum":8593,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8593,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8593,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8593,"methodology":"case rate"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2312","type":"APR-DRG"}],"standard_charges":[{"minimum":10982,"maximum":10982,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10982,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10982,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10982,"methodology":"case rate"}]}]},{"description":"PARTIAL REMOVAL COLLAR BONE","code_information":[{"code":"23120","type":"CPT"}],"standard_charges":[{"minimum":621.57,"maximum":4367,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1284.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":621.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":621.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":621.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF COLLAR BONE","code_information":[{"code":"23125","type":"CPT"}],"standard_charges":[{"minimum":749.2,"maximum":4367,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1549.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":749.2,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":749.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":749.2,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2313","type":"APR-DRG"}],"standard_charges":[{"minimum":16917,"maximum":16917,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":16917,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":16917,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":16917,"methodology":"case rate"}]}]},{"description":"REMOVE SHOULDER BONE PART","code_information":[{"code":"23130","type":"CPT"}],"standard_charges":[{"minimum":654.02,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1352.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":654.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":654.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":654.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2314","type":"APR-DRG"}],"standard_charges":[{"minimum":28816,"maximum":28816,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":28816,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":28816,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":28816,"methodology":"case rate"}]}]},{"description":"REMOVAL OF BONE LESION","code_information":[{"code":"23140","type":"CPT"}],"standard_charges":[{"minimum":588.04,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1215.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":588.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":588.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":588.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF BONE LESION","code_information":[{"code":"23145","type":"CPT"}],"standard_charges":[{"minimum":734.78,"maximum":4367,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1519.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":734.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":734.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":734.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF BONE LESION","code_information":[{"code":"23146","type":"CPT"}],"standard_charges":[{"minimum":659.42,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1363.27,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":659.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":659.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":659.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF HUMERUS LESION","code_information":[{"code":"23150","type":"CPT"}],"standard_charges":[{"minimum":704.85,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1457.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF HUMERUS LESION","code_information":[{"code":"23155","type":"CPT"}],"standard_charges":[{"minimum":841.5,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1739.67,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":841.5,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":841.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":841.5,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF HUMERUS LESION","code_information":[{"code":"23156","type":"CPT"}],"standard_charges":[{"minimum":717.47,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1483.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":717.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":717.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":717.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE COLLAR BONE LESION","code_information":[{"code":"23170","type":"CPT"}],"standard_charges":[{"minimum":597.41,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1235.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":597.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":597.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":597.41,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE SHOULDER BLADE LESION","code_information":[{"code":"23172","type":"CPT"}],"standard_charges":[{"minimum":603.9,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1248.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":603.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":603.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":603.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE HUMERUS LESION","code_information":[{"code":"23174","type":"CPT"}],"standard_charges":[{"minimum":806.16,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1667.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":806.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":806.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":806.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE COLLAR BONE LESION","code_information":[{"code":"23180","type":"CPT"}],"standard_charges":[{"minimum":695.84,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1439.06,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":695.84,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":695.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":695.84,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE SHOULDER BLADE LESION","code_information":[{"code":"23182","type":"CPT"}],"standard_charges":[{"minimum":709.9,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1467.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":709.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":709.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":709.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE HUMERUS LESION","code_information":[{"code":"23184","type":"CPT"}],"standard_charges":[{"minimum":781.65,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1616.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":781.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":781.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":781.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"PARTIAL REMOVAL OF SCAPULA","code_information":[{"code":"23190","type":"CPT"}],"standard_charges":[{"minimum":608.95,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1259.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF HEAD OF HUMERUS","code_information":[{"code":"23195","type":"CPT"}],"standard_charges":[{"minimum":783.45,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1620.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.45,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":783.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITH PTCA WITHOUT MCC","code_information":[{"code":"232","type":"MS-DRG"}],"standard_charges":[{"minimum":74390.05,"maximum":131574.35,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131574.35,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":98683.86,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":98683.86,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":84452.27,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":84452.27,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":86778.18,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103048,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":85077,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":117104,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":74390.05,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":75133.96,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":76621.76,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":75877.86,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":74390.05,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":74390.05,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":74390.05,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":75133.96,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":74390.05,"methodology":"case rate"}]}]},{"description":"RESECT CLAVICLE TUMOR","code_information":[{"code":"23200","type":"CPT"}],"standard_charges":[{"minimum":1573.75,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3254.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1573.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1573.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1573.75,"methodology":"fee schedule"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2321","type":"APR-DRG"}],"standard_charges":[{"minimum":6141,"maximum":6141,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6141,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6141,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6141,"methodology":"case rate"}]}]},{"description":"RESECT SCAPULA TUMOR","code_information":[{"code":"23210","type":"CPT"}],"standard_charges":[{"minimum":1845.23,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3815.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1845.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1845.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1845.23,"methodology":"fee schedule"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2322","type":"APR-DRG"}],"standard_charges":[{"minimum":8118,"maximum":8118,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8118,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8118,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8118,"methodology":"case rate"}]}]},{"description":"RESECT PROX HUMERUS TUMOR","code_information":[{"code":"23220","type":"CPT"}],"standard_charges":[{"minimum":2021.9,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4180.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2021.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2021.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2021.9,"methodology":"fee schedule"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2323","type":"APR-DRG"}],"standard_charges":[{"minimum":12795,"maximum":12795,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12795,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12795,"methodology":"case rate"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2324","type":"APR-DRG"}],"standard_charges":[{"minimum":44021,"maximum":44021,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":44021,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":44021,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":44021,"methodology":"case rate"}]}]},{"description":"CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC","code_information":[{"code":"233","type":"MS-DRG"}],"standard_charges":[{"minimum":87932.48,"maximum":153543,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":147522.66,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":110645.46,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":110645.46,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110730.92,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":110730.92,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":113780.56,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":135112,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":111550,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":153543,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":87932.48,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":88811.81,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":90570.46,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":89691.13,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":87932.48,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":87932.48,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":87932.48,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":88811.81,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":87932.48,"methodology":"case rate"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2331","type":"APR-DRG"}],"standard_charges":[{"minimum":6148,"maximum":6148,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6148,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6148,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6148,"methodology":"case rate"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2332","type":"APR-DRG"}],"standard_charges":[{"minimum":7993,"maximum":7993,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7993,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7993,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7993,"methodology":"case rate"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2333","type":"APR-DRG"}],"standard_charges":[{"minimum":11845,"maximum":11845,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":11845,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":11845,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":11845,"methodology":"case rate"}]}]},{"description":"REMOVE SHOULDER FOREIGN BODY","code_information":[{"code":"23330","type":"CPT"}],"standard_charges":[{"minimum":175.58,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":363.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":175.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":175.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":175.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"REMOVE SHOULDER FB DEEP","code_information":[{"code":"23333","type":"CPT"}],"standard_charges":[{"minimum":500.07,"maximum":2724.13,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1034.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":500.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":500.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":500.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"SHOULDER PROSTHESIS REMOVAL","code_information":[{"code":"23334","type":"CPT"}],"standard_charges":[{"minimum":1109.38,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2293.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1109.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1109.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1109.38,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"SHOULDER PROSTHESIS REMOVAL","code_information":[{"code":"23335","type":"CPT"}],"standard_charges":[{"minimum":1326.78,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2743.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1326.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1326.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1326.78,"methodology":"fee schedule"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2334","type":"APR-DRG"}],"standard_charges":[{"minimum":19951,"maximum":19951,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":19951,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":19951,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":19951,"methodology":"case rate"}]}]},{"description":"ARTHROGRAM SHOULDER INJ UNI","code_information":[{"code":"23350","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":173.31,"maximum":267.159,"gross_charge":327,"discounted_cash":130.8,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":173.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":267.16,"methodology":"fee schedule"}]}]},{"description":"ARTHROGRAM SHOULDER INJ UNI","code_information":[{"code":"23350","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":52.28,"maximum":267.159,"gross_charge":327,"discounted_cash":130.8,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":173.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":267.16,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.28,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":52.28,"methodology":"fee schedule"}]}]},{"description":"MUSCLE TRANSFER SHOULDER/ARM","code_information":[{"code":"23395","type":"CPT"}],"standard_charges":[{"minimum":1343.36,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2777.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1343.36,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1343.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1343.36,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"MUSCLE TRANSFERS","code_information":[{"code":"23397","type":"CPT"}],"standard_charges":[{"minimum":1194.82,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2470.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1194.82,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1194.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1194.82,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC","code_information":[{"code":"234","type":"MS-DRG"}],"standard_charges":[{"minimum":68897.73,"maximum":112572.93,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":112572.93,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":84432.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":84432.34,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73794.59,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":73794.59,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":75826.97,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":90043,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":74340,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":102326,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":68897.73,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":69586.71,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":70964.67,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":70275.69,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":68897.73,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":68897.73,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":68897.73,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":69586.71,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":68897.73,"methodology":"case rate"}]}]},{"description":"FIXATION OF SHOULDER BLADE","code_information":[{"code":"23400","type":"CPT"}],"standard_charges":[{"minimum":1022.85,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2114.95,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1022.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1022.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1022.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"INCISION OF TENDON  MUSCLE","code_information":[{"code":"23405","type":"CPT"}],"standard_charges":[{"minimum":650.77,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1345.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":650.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":650.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":650.77,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"INCISE TENDON(S)  MUSCLE(S)","code_information":[{"code":"23406","type":"CPT"}],"standard_charges":[{"minimum":787.41,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1628.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":787.41,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":787.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":787.41,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2341","type":"APR-DRG"}],"standard_charges":[{"minimum":5519,"maximum":5519,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5519,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5519,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5519,"methodology":"case rate"}]}]},{"description":"REPAIR ROTATOR CUFF ACUTE","code_information":[{"code":"23410","type":"CPT"}],"standard_charges":[{"minimum":863.49,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1785.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":863.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":863.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":863.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR ROTATOR CUFF CHRONIC","code_information":[{"code":"23412","type":"CPT"}],"standard_charges":[{"minimum":897.02,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1854.69,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":897.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":897.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":897.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"RELEASE OF SHOULDER LIGAMENT","code_information":[{"code":"23415","type":"CPT"}],"standard_charges":[{"minimum":736.94,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1523.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":736.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":736.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":736.94,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2342","type":"APR-DRG"}],"standard_charges":[{"minimum":6858,"maximum":6858,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6858,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6858,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6858,"methodology":"case rate"}]}]},{"description":"REPAIR OF SHOULDER","code_information":[{"code":"23420","type":"CPT"}],"standard_charges":[{"minimum":1024.29,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2118.36,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1024.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1024.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1024.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2343","type":"APR-DRG"}],"standard_charges":[{"minimum":10226,"maximum":10226,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10226,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10226,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10226,"methodology":"case rate"}]}]},{"description":"REPAIR BICEPS TENDON","code_information":[{"code":"23430","type":"CPT"}],"standard_charges":[{"minimum":784.53,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1622.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":784.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2344","type":"APR-DRG"}],"standard_charges":[{"minimum":19445,"maximum":19445,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":19445,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":19445,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":19445,"methodology":"case rate"}]}]},{"description":"REMOVE/TRANSPLANT TENDON","code_information":[{"code":"23440","type":"CPT"}],"standard_charges":[{"minimum":796.43,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1647.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":796.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":796.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":796.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR SHOULDER CAPSULE","code_information":[{"code":"23450","type":"CPT"}],"standard_charges":[{"minimum":994,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2055.22,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":994,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":994,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":994,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR SHOULDER CAPSULE","code_information":[{"code":"23455","type":"CPT"}],"standard_charges":[{"minimum":1038.35,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2147.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1038.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1038.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1038.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR SHOULDER CAPSULE","code_information":[{"code":"23460","type":"CPT"}],"standard_charges":[{"minimum":1144.35,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2366.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1144.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1144.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1144.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR SHOULDER CAPSULE","code_information":[{"code":"23462","type":"CPT"}],"standard_charges":[{"minimum":1120.19,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2316.58,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1120.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1120.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1120.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR SHOULDER CAPSULE","code_information":[{"code":"23465","type":"CPT"}],"standard_charges":[{"minimum":1173.55,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2426.51,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1173.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1173.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1173.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR SHOULDER CAPSULE","code_information":[{"code":"23466","type":"CPT"}],"standard_charges":[{"minimum":1177.16,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2434.39,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1177.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1177.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1177.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT SHOULDER JOINT","code_information":[{"code":"23470","type":"CPT"}],"standard_charges":[{"minimum":1255.03,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2595.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1255.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1255.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1255.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT SHOULDER JOINT","code_information":[{"code":"23472","type":"CPT"}],"standard_charges":[{"minimum":1512.46,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8327.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":8327.6,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":8327.6,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3127.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1512.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1512.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1512.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REVIS RECONST SHOULDER JOINT","code_information":[{"code":"23473","type":"CPT"}],"standard_charges":[{"minimum":1683.71,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3481.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1683.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1683.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1683.71,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REVIS RECONST SHOULDER JOINT","code_information":[{"code":"23474","type":"CPT"}],"standard_charges":[{"minimum":1817.47,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3758,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1817.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1817.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1817.47,"methodology":"fee schedule"}]}]},{"description":"REVISION OF COLLAR BONE","code_information":[{"code":"23480","type":"CPT"}],"standard_charges":[{"minimum":863.85,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1786.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":863.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":863.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":863.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REVISION OF COLLAR BONE","code_information":[{"code":"23485","type":"CPT"}],"standard_charges":[{"minimum":1002.3,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2072.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1002.3,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1002.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1002.3,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REINFORCE CLAVICLE","code_information":[{"code":"23490","type":"CPT"}],"standard_charges":[{"minimum":906.03,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1873.26,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":906.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REINFORCE SHOULDER BONES","code_information":[{"code":"23491","type":"CPT"}],"standard_charges":[{"minimum":1066.83,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2206.29,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1066.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1066.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1066.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC","code_information":[{"code":"235","type":"MS-DRG"}],"standard_charges":[{"minimum":73892.55,"maximum":115765,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":115689.85,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":86770.11,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":86770.11,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83486.88,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":83486.88,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":85786.19,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":101870,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":84104,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":115765,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":73892.55,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":74631.48,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":76109.33,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":75370.41,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":73892.55,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":73892.55,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":73892.55,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":74631.48,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":73892.55,"methodology":"case rate"}]}]},{"description":"TREAT CLAVICLE FRACTURE","code_information":[{"code":"23500","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":508.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":245.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":245.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":245.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE FRACTURE","code_information":[{"code":"23505","type":"CPT"}],"standard_charges":[{"minimum":357.29,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":738.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":357.29,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":357.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":357.29,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE FRACTURE","code_information":[{"code":"23515","type":"CPT"}],"standard_charges":[{"minimum":760.74,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1572.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":760.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":760.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":760.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23520","type":"CPT"}],"standard_charges":[{"minimum":256.34,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1551.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1551.38,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1551.38,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":529.74,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":256.34,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":256.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":256.34,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23525","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":804.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":389.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":389.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":389.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23530","type":"CPT"}],"standard_charges":[{"minimum":610.03,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1261.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":610.03,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":610.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":610.03,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23532","type":"CPT"}],"standard_charges":[{"minimum":662.67,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1370.45,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":662.67,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":662.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":662.67,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23540","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":526.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":254.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":254.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":254.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23545","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":716.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":346.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":346.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":346.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23550","type":"CPT"}],"standard_charges":[{"minimum":605.7,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1252.72,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":605.7,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":605.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":605.7,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT CLAVICLE DISLOCATION","code_information":[{"code":"23552","type":"CPT"}],"standard_charges":[{"minimum":684.66,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1415.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":684.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":684.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":684.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT SHOULDER BLADE FX","code_information":[{"code":"23570","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":538.54,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":260.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":260.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":260.31,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT SHOULDER BLADE FX","code_information":[{"code":"23575","type":"CPT"}],"standard_charges":[{"minimum":405.97,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":839.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":405.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":405.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":405.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT SCAPULA FRACTURE","code_information":[{"code":"23585","type":"CPT"}],"standard_charges":[{"minimum":1026.09,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2122.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1026.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1026.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1026.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC","code_information":[{"code":"236","type":"MS-DRG"}],"standard_charges":[{"minimum":57372.92,"maximum":84000.6,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":84000.6,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":63002.42,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":63002.42,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57372.92,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":57372.92,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":58953.03,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70006,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":57797,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":79555,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":60434.99,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":61039.34,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":62248.04,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":61643.69,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":60434.99,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":60434.99,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":60434.99,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":61039.34,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":60434.99,"methodology":"case rate"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"23600","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":702.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":339.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":339.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":339.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"23605","type":"CPT"}],"standard_charges":[{"minimum":456.44,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":944.17,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":456.44,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":456.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":456.44,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"23615","type":"CPT"}],"standard_charges":[{"minimum":929.47,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1921.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":929.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":929.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":929.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"23616","type":"CPT"}],"standard_charges":[{"minimum":1295.77,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2679.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1295.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1295.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1295.77,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"23620","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":578.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":279.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":279.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":279.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"23625","type":"CPT"}],"standard_charges":[{"minimum":381.09,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":787.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.09,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.09,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"23630","type":"CPT"}],"standard_charges":[{"minimum":823.11,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1701.79,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":823.11,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":823.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":823.11,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT SHOULDER DISLOCATION","code_information":[{"code":"23650","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":665.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":321.6,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":321.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":321.6,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT SHOULDER DISLOCATION","code_information":[{"code":"23655","type":"CPT"}],"standard_charges":[{"minimum":434.45,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":898.11,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":434.45,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":434.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":434.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT SHOULDER DISLOCATION","code_information":[{"code":"23660","type":"CPT"}],"standard_charges":[{"minimum":620.85,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1284.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":620.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":620.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":620.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT DISLOCATION/FRACTURE","code_information":[{"code":"23665","type":"CPT"}],"standard_charges":[{"minimum":426.88,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":882.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":426.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":426.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":426.88,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT DISLOCATION/FRACTURE","code_information":[{"code":"23670","type":"CPT"}],"standard_charges":[{"minimum":916.49,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1894.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":916.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":916.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":916.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT DISLOCATION/FRACTURE","code_information":[{"code":"23675","type":"CPT"}],"standard_charges":[{"minimum":532.51,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":532.51,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":532.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":532.51,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT DISLOCATION/FRACTURE","code_information":[{"code":"23680","type":"CPT"}],"standard_charges":[{"minimum":977.78,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2021.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":977.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":977.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":977.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"FIXATION OF SHOULDER","code_information":[{"code":"23700","type":"CPT"}],"standard_charges":[{"minimum":206.59,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":427.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":206.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":206.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":206.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"FUSION OF SHOULDER JOINT","code_information":[{"code":"23800","type":"CPT"}],"standard_charges":[{"minimum":1078.37,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2230.18,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1078.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1078.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1078.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"FUSION OF SHOULDER JOINT","code_information":[{"code":"23802","type":"CPT"}],"standard_charges":[{"minimum":1345.17,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":5144,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2781.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1345.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC","code_information":[{"code":"239","type":"MS-DRG"}],"standard_charges":[{"minimum":51095.85,"maximum":94627,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68125.67,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":51095.85,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":51095.85,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68242.14,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":68242.14,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":70121.6,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83268,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":68747,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":94627,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":66036.33,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":66696.7,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":68017.42,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":67357.06,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":66036.33,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":66036.33,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":66036.33,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":66696.7,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":66036.33,"methodology":"case rate"}]}]},{"description":"AMPUTATION OF ARM  GIRDLE","code_information":[{"code":"23900","type":"CPT"}],"standard_charges":[{"minimum":1449.72,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2997.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1449.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1449.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1449.72,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION AT SHOULDER JOINT","code_information":[{"code":"23920","type":"CPT"}],"standard_charges":[{"minimum":1177.52,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2435,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1177.52,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1177.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1177.52,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FOLLOW-UP SURGERY","code_information":[{"code":"23921","type":"CPT"}],"standard_charges":[{"minimum":498.62,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1031.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":498.62,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":498.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":498.62,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1819.98,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1802.31,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1784.64,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1766.97,"methodology":"fee schedule"}]}]},{"description":"SHOULDER SURGERY PROCEDURE","code_information":[{"code":"23929","type":"CPT"}],"standard_charges":[{"minimum":153.97,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF ARM LESION","code_information":[{"code":"23930","type":"CPT"}],"standard_charges":[{"minimum":226.42,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":468.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF ARM BURSA","code_information":[{"code":"23931","type":"CPT"}],"standard_charges":[{"minimum":169.81,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":351.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.81,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.81,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"DRAIN ARM/ELBOW BONE LESION","code_information":[{"code":"23935","type":"CPT"}],"standard_charges":[{"minimum":543.69,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1124.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":543.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":543.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":543.69,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC","code_information":[{"code":"240","type":"MS-DRG"}],"standard_charges":[{"minimum":38830.36,"maximum":55302,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51772.19,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":38830.36,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":38830.36,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39882.21,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":39882.21,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":40980.61,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48664,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":40177,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":55302,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":51421.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":51935.56,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":52963.99,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":52449.77,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":51421.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":51421.34,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":51421.34,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":51935.56,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":51421.34,"methodology":"case rate"}]}]},{"description":"EXPLORATORY ELBOW SURGERY","code_information":[{"code":"24000","type":"CPT"}],"standard_charges":[{"minimum":506.92,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1048.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":506.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":506.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":506.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"RELEASE ELBOW JOINT","code_information":[{"code":"24006","type":"CPT"}],"standard_charges":[{"minimum":751.72,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1554.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":751.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":751.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":751.72,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2401","type":"APR-DRG"}],"standard_charges":[{"minimum":4943,"maximum":4943,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4943,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4943,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4943,"methodology":"case rate"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2402","type":"APR-DRG"}],"standard_charges":[{"minimum":5691,"maximum":5691,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5691,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5691,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5691,"methodology":"case rate"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2403","type":"APR-DRG"}],"standard_charges":[{"minimum":8037,"maximum":8037,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":8037,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":8037,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":8037,"methodology":"case rate"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2404","type":"APR-DRG"}],"standard_charges":[{"minimum":14978,"maximum":14978,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":14978,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":14978,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":14978,"methodology":"case rate"}]}]},{"description":"BIOPSY ARM/ELBOW SOFT TISSUE","code_information":[{"code":"24065","type":"CPT"}],"standard_charges":[{"minimum":170.53,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":352.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BIOPSY ARM/ELBOW SOFT TISSUE","code_information":[{"code":"24066","type":"CPT"}],"standard_charges":[{"minimum":444.18,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":918.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":444.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":444.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":444.18,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC ARM/ELBOW LES SC 3 CM/>","code_information":[{"code":"24071","type":"CPT"}],"standard_charges":[{"minimum":426.16,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":881.3,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":426.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":426.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":426.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EX ARM/ELBOW TUM DEEP 5 CM/>","code_information":[{"code":"24073","type":"CPT"}],"standard_charges":[{"minimum":727.93,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1505.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":727.93,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":727.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":727.93,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"EXC ARM/ELBOW LES SC < 3 CM","code_information":[{"code":"24075","type":"CPT"}],"standard_charges":[{"minimum":347.92,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":719.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.92,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":347.92,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"EX ARM/ELBOW TUM DEEP < 5 CM","code_information":[{"code":"24076","type":"CPT"}],"standard_charges":[{"minimum":577.22,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1193.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":577.22,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":577.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":577.22,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT ARM/ELBOW TUM < 5 CM","code_information":[{"code":"24077","type":"CPT"}],"standard_charges":[{"minimum":1081.97,"maximum":3053,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2237.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1081.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1081.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1081.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"RESECT ARM/ELBOW TUM 5 CM/>","code_information":[{"code":"24079","type":"CPT"}],"standard_charges":[{"minimum":1384.83,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2863.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1384.83,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1384.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1384.83,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC","code_information":[{"code":"241","type":"MS-DRG"}],"standard_charges":[{"minimum":19790.62,"maximum":42667.07,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42667.07,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":32001.31,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":32001.31,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19790.62,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":19790.62,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":20335.67,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24148,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":19937,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":27442,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":41067.34,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":41478.02,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":42299.37,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":41888.69,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":41067.34,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":41067.34,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":41067.34,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":41478.02,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":41067.34,"methodology":"case rate"}]}]},{"description":"BIOPSY ELBOW JOINT LINING","code_information":[{"code":"24100","type":"CPT"}],"standard_charges":[{"minimum":445.62,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":921.14,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":445.62,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":445.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":445.62,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"EXPLORE/TREAT ELBOW JOINT","code_information":[{"code":"24101","type":"CPT"}],"standard_charges":[{"minimum":535.04,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1106.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":535.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":535.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":535.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE ELBOW JOINT LINING","code_information":[{"code":"24102","type":"CPT"}],"standard_charges":[{"minimum":651.49,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1347.02,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":651.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":651.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":651.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF ELBOW BURSA","code_information":[{"code":"24105","type":"CPT"}],"standard_charges":[{"minimum":382.53,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":791.32,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2411","type":"APR-DRG"}],"standard_charges":[{"minimum":3901,"maximum":3901,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3901,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3901,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3901,"methodology":"case rate"}]}]},{"description":"REMOVE HUMERUS LESION","code_information":[{"code":"24110","type":"CPT"}],"standard_charges":[{"minimum":625.17,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1292.9,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.17,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.17,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE/GRAFT BONE LESION","code_information":[{"code":"24115","type":"CPT"}],"standard_charges":[{"minimum":778.04,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1608.97,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":778.04,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":778.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":778.04,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE/GRAFT BONE LESION","code_information":[{"code":"24116","type":"CPT"}],"standard_charges":[{"minimum":905.31,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1871.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":905.31,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":905.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":905.31,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2412","type":"APR-DRG"}],"standard_charges":[{"minimum":4756,"maximum":4756,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4756,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4756,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4756,"methodology":"case rate"}]}]},{"description":"REMOVE ELBOW LESION","code_information":[{"code":"24120","type":"CPT"}],"standard_charges":[{"minimum":564.24,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1167.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":564.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":564.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":564.24,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE/GRAFT BONE LESION","code_information":[{"code":"24125","type":"CPT"}],"standard_charges":[{"minimum":658.7,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1361.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":658.7,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":658.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":658.7,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE/GRAFT BONE LESION","code_information":[{"code":"24126","type":"CPT"}],"standard_charges":[{"minimum":687.55,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1422.01,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":687.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":687.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":687.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2413","type":"APR-DRG"}],"standard_charges":[{"minimum":7004,"maximum":7004,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":7004,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":7004,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":7004,"methodology":"case rate"}]}]},{"description":"REMOVAL OF HEAD OF RADIUS","code_information":[{"code":"24130","type":"CPT"}],"standard_charges":[{"minimum":544.05,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1124.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":544.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":544.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":544.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF ARM BONE LESION","code_information":[{"code":"24134","type":"CPT"}],"standard_charges":[{"minimum":788.5,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1630.62,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":788.5,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":788.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":788.5,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVE RADIUS BONE LESION","code_information":[{"code":"24136","type":"CPT"}],"standard_charges":[{"minimum":668.8,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1382.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":668.8,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":668.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":668.8,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE ELBOW BONE LESION","code_information":[{"code":"24138","type":"CPT"}],"standard_charges":[{"minimum":727.21,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1503.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":727.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":727.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":727.21,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2414","type":"APR-DRG"}],"standard_charges":[{"minimum":15240,"maximum":15240,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15240,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15240,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15240,"methodology":"case rate"}]}]},{"description":"PARTIAL REMOVAL OF ARM BONE","code_information":[{"code":"24140","type":"CPT"}],"standard_charges":[{"minimum":743.07,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1536.66,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":743.07,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":743.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":743.07,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"PARTIAL REMOVAL OF RADIUS","code_information":[{"code":"24145","type":"CPT"}],"standard_charges":[{"minimum":628.78,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1300.46,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":628.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":628.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":628.78,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"PARTIAL REMOVAL OF ELBOW","code_information":[{"code":"24147","type":"CPT"}],"standard_charges":[{"minimum":665.55,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1376.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":665.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":665.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":665.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"RADICAL RESECTION OF ELBOW","code_information":[{"code":"24149","type":"CPT"}],"standard_charges":[{"minimum":1240.61,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2565.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1240.61,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1240.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1240.61,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"RESECT DISTAL HUMERUS TUMOR","code_information":[{"code":"24150","type":"CPT"}],"standard_charges":[{"minimum":1614.13,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3337.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1614.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1614.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1614.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"RESECT RADIUS TUMOR","code_information":[{"code":"24152","type":"CPT"}],"standard_charges":[{"minimum":1405.38,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2906,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1405.38,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1405.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1405.38,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF ELBOW JOINT","code_information":[{"code":"24155","type":"CPT"}],"standard_charges":[{"minimum":897.02,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1854.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":897.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":897.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":897.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE ELBOW JOINT IMPLANT","code_information":[{"code":"24160","type":"CPT"}],"standard_charges":[{"minimum":1316.32,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2721.99,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1316.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1316.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1316.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REMOVE RADIUS HEAD IMPLANT","code_information":[{"code":"24164","type":"CPT"}],"standard_charges":[{"minimum":763.98,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1580.08,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.98,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.98,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC","code_information":[{"code":"242","type":"MS-DRG"}],"standard_charges":[{"minimum":49052.05,"maximum":70949.08,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70949.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":53213.48,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":53213.48,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49052.05,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":49052.05,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":50403,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59853,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":49415,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":68017,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":56146.92,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":56708.39,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":57831.33,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":57269.86,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":56146.92,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":56146.92,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":56146.92,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":56708.39,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":56146.92,"methodology":"case rate"}]}]},{"description":"REMOVAL OF ARM FOREIGN BODY","code_information":[{"code":"24200","type":"CPT"}],"standard_charges":[{"minimum":146.74,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":303.31,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"REMOVAL OF ARM FOREIGN BODY","code_information":[{"code":"24201","type":"CPT"}],"standard_charges":[{"minimum":387.58,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":801.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":387.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":387.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":387.58,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":2724.13,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":2697.68,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":2671.23,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.78,"methodology":"fee schedule"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2421","type":"APR-DRG"}],"standard_charges":[{"minimum":3546,"maximum":3546,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3546,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3546,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3546,"methodology":"case rate"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2422","type":"APR-DRG"}],"standard_charges":[{"minimum":4540,"maximum":4540,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4540,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4540,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4540,"methodology":"case rate"}]}]},{"description":"ARTHROGRAM ELBOW INJ","code_information":[{"code":"24220","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":160.59,"maximum":247.551,"gross_charge":303,"discounted_cash":121.2,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":160.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":247.56,"methodology":"fee schedule"}]}]},{"description":"ARTHROGRAM ELBOW INJ","code_information":[{"code":"24220","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":69.58,"maximum":247.551,"gross_charge":303,"discounted_cash":121.2,"setting":"outpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_dollar":160.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_dollar":247.56,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.58,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.58,"methodology":"fee schedule"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2423","type":"APR-DRG"}],"standard_charges":[{"minimum":6604,"maximum":6604,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6604,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6604,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6604,"methodology":"case rate"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2424","type":"APR-DRG"}],"standard_charges":[{"minimum":15416,"maximum":15416,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":15416,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":15416,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":15416,"methodology":"case rate"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC","code_information":[{"code":"243","type":"MS-DRG"}],"standard_charges":[{"minimum":32335.09,"maximum":55482.51,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55482.51,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":41613.18,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":41613.18,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32335.09,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":32335.09,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":33225.63,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39455,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":32574,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":44837,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":47532.01,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":48007.34,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":48957.98,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":48482.66,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":47532.01,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":47532.01,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":47532.01,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":48007.34,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":47532.01,"methodology":"case rate"}]}]},{"description":"MANIPULATE ELBOW W/ANESTH","code_information":[{"code":"24300","type":"CPT"}],"standard_charges":[{"minimum":463.65,"maximum":3060,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":958.61,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":463.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":463.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":463.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"MUSCLE/TENDON TRANSFER","code_information":[{"code":"24301","type":"CPT"}],"standard_charges":[{"minimum":793.9,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1641.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":793.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":793.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":793.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"ARM TENDON LENGTHENING","code_information":[{"code":"24305","type":"CPT"}],"standard_charges":[{"minimum":612.91,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1267.57,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":612.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":612.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":612.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2431","type":"APR-DRG"}],"standard_charges":[{"minimum":3611,"maximum":3611,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3611,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3611,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3611,"methodology":"case rate"}]}]},{"description":"REVISION OF ARM TENDON","code_information":[{"code":"24310","type":"CPT"}],"standard_charges":[{"minimum":504.39,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1042.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":504.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":504.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":504.39,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2432","type":"APR-DRG"}],"standard_charges":[{"minimum":4337,"maximum":4337,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4337,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4337,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4337,"methodology":"case rate"}]}]},{"description":"REPAIR OF ARM TENDON","code_information":[{"code":"24320","type":"CPT"}],"standard_charges":[{"minimum":822.75,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1700.91,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":822.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":822.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":822.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2433","type":"APR-DRG"}],"standard_charges":[{"minimum":6333,"maximum":6333,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6333,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6333,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6333,"methodology":"case rate"}]}]},{"description":"REVISION OF ARM MUSCLES","code_information":[{"code":"24330","type":"CPT"}],"standard_charges":[{"minimum":758.21,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1567.63,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":758.21,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":758.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":758.21,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REVISION OF ARM MUSCLES","code_information":[{"code":"24331","type":"CPT"}],"standard_charges":[{"minimum":827.43,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1711.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":827.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":827.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":827.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TENOLYSIS TRICEPS","code_information":[{"code":"24332","type":"CPT"}],"standard_charges":[{"minimum":651.13,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1346.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":651.13,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":651.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":651.13,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2434","type":"APR-DRG"}],"standard_charges":[{"minimum":12531,"maximum":12531,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12531,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12531,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12531,"methodology":"case rate"}]}]},{"description":"REPAIR OF BICEPS TENDON","code_information":[{"code":"24340","type":"CPT"}],"standard_charges":[{"minimum":634.91,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1312.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":634.91,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":634.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":634.91,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR ARM TENDON/MUSCLE","code_information":[{"code":"24341","type":"CPT"}],"standard_charges":[{"minimum":789.22,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1631.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":789.22,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":789.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":789.22,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPAIR OF RUPTURED TENDON","code_information":[{"code":"24342","type":"CPT"}],"standard_charges":[{"minimum":816.26,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1688.15,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":816.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":816.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":816.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPR ELBOW LAT LIGMNT W/TISS","code_information":[{"code":"24343","type":"CPT"}],"standard_charges":[{"minimum":754.97,"maximum":3776,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1561.19,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":754.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":754.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":754.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ELBOW LAT LIGMNT","code_information":[{"code":"24344","type":"CPT"}],"standard_charges":[{"minimum":1147.95,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5482,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5482,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2374,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1147.95,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1147.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1147.95,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REPR ELBW MED LIGMNT W/TISSU","code_information":[{"code":"24345","type":"CPT"}],"standard_charges":[{"minimum":750.64,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1552.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":750.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":750.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":750.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ELBOW MED LIGMNT","code_information":[{"code":"24346","type":"CPT"}],"standard_charges":[{"minimum":1160.57,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2400.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1160.57,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1160.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1160.57,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REPAIR ELBOW PERC","code_information":[{"code":"24357","type":"CPT"}],"standard_charges":[{"minimum":443.1,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":916.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":443.1,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":443.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":443.1,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REPAIR ELBOW W/DEB OPEN","code_information":[{"code":"24358","type":"CPT"}],"standard_charges":[{"minimum":560.64,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1159.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":560.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":560.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":560.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"REPAIR ELBOW DEB/ATTCH OPEN","code_information":[{"code":"24359","type":"CPT"}],"standard_charges":[{"minimum":700.89,"maximum":6977,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":6977,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1449.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":700.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":700.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":700.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ELBOW JOINT","code_information":[{"code":"24360","type":"CPT"}],"standard_charges":[{"minimum":950.02,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1964.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":950.02,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":950.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":950.02,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ELBOW JOINT","code_information":[{"code":"24361","type":"CPT"}],"standard_charges":[{"minimum":1058.54,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2188.96,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1058.54,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1058.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1058.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT ELBOW JOINT","code_information":[{"code":"24362","type":"CPT"}],"standard_charges":[{"minimum":1114.06,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2303.93,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1114.06,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1114.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1114.06,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REPLACE ELBOW JOINT","code_information":[{"code":"24363","type":"CPT"}],"standard_charges":[{"minimum":1516.42,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3135.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1516.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1516.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1516.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT HEAD OF RADIUS","code_information":[{"code":"24365","type":"CPT"}],"standard_charges":[{"minimum":677.45,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1400.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":677.45,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":677.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":677.45,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT HEAD OF RADIUS","code_information":[{"code":"24366","type":"CPT"}],"standard_charges":[{"minimum":718.55,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1485.48,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":718.55,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":718.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":718.55,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REVISE RECONST ELBOW JOINT","code_information":[{"code":"24370","type":"CPT"}],"standard_charges":[{"minimum":1610.16,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3329.7,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1610.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1610.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1610.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REVISE RECONST ELBOW JOINT","code_information":[{"code":"24371","type":"CPT"}],"standard_charges":[{"minimum":1848.12,"maximum":23091.81,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":5702,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":5890.44,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":3821.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4131,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":3274,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":4211,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1848.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1848.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1848.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":23091.81,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":22867.62,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":22643.43,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":22419.23,"methodology":"fee schedule"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC","code_information":[{"code":"244","type":"MS-DRG"}],"standard_charges":[{"minimum":25973.41,"maximum":46520.95,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46520.95,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":34891.81,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":34891.81,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25973.41,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":25973.41,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":26688.75,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31692,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":26166,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":36016,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":44253.58,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":44696.12,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":45581.19,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":45138.66,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":44253.58,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":44253.58,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":44253.58,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":44696.12,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":44253.58,"methodology":"case rate"}]}]},{"description":"REVISION OF HUMERUS","code_information":[{"code":"24400","type":"CPT"}],"standard_charges":[{"minimum":872.14,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1803.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":872.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":872.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":872.14,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2441","type":"APR-DRG"}],"standard_charges":[{"minimum":3213,"maximum":3213,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3213,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3213,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3213,"methodology":"case rate"}]}]},{"description":"REVISION OF HUMERUS","code_information":[{"code":"24410","type":"CPT"}],"standard_charges":[{"minimum":1111.18,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2297.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1111.18,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2442","type":"APR-DRG"}],"standard_charges":[{"minimum":4264,"maximum":4264,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4264,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4264,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4264,"methodology":"case rate"}]}]},{"description":"REVISION OF HUMERUS","code_information":[{"code":"24420","type":"CPT"}],"standard_charges":[{"minimum":1121.27,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2318.78,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1121.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1121.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1121.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2443","type":"APR-DRG"}],"standard_charges":[{"minimum":6649,"maximum":6649,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6649,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6649,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6649,"methodology":"case rate"}]}]},{"description":"REPAIR OF HUMERUS","code_information":[{"code":"24430","type":"CPT"}],"standard_charges":[{"minimum":1108.65,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2292.4,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1108.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1108.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1108.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"REPAIR HUMERUS WITH GRAFT","code_information":[{"code":"24435","type":"CPT"}],"standard_charges":[{"minimum":1133.89,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2344.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1133.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1133.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1133.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2444","type":"APR-DRG"}],"standard_charges":[{"minimum":12833,"maximum":12833,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12833,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12833,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12833,"methodology":"case rate"}]}]},{"description":"REVISION OF ELBOW JOINT","code_information":[{"code":"24470","type":"CPT"}],"standard_charges":[{"minimum":710.26,"maximum":6300,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1468.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":710.26,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":710.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":710.26,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"DECOMPRESSION OF FOREARM","code_information":[{"code":"24495","type":"CPT"}],"standard_charges":[{"minimum":977.42,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2021.25,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":977.42,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":977.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":977.42,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"REINFORCE HUMERUS","code_information":[{"code":"24498","type":"CPT"}],"standard_charges":[{"minimum":912.16,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1886.37,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":912.16,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":912.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":912.16,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"AICD GENERATOR PROCEDURES","code_information":[{"code":"245","type":"MS-DRG"}],"standard_charges":[{"minimum":53105.8,"maximum":89205,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70805.52,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":53105.8,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":53105.8,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":64332.29,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":64332.29,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":66104.06,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78497,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":64808,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":89205,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":64021.43,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":64661.65,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":65942.08,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":65301.86,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":64021.43,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":64021.43,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":64021.43,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":64661.65,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":64021.43,"methodology":"case rate"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24500","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":742.13,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":358.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":358.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":358.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24505","type":"CPT"}],"standard_charges":[{"minimum":483.12,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":999.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":483.12,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":483.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":483.12,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2451","type":"APR-DRG"}],"standard_charges":[{"minimum":3620,"maximum":3620,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3620,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3620,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3620,"methodology":"case rate"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24515","type":"CPT"}],"standard_charges":[{"minimum":927.66,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1918.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":927.66,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":927.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":927.66,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24516","type":"CPT"}],"standard_charges":[{"minimum":904.23,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1870,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":904.23,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":904.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":904.23,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2452","type":"APR-DRG"}],"standard_charges":[{"minimum":4594,"maximum":4594,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4594,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4594,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4594,"methodology":"case rate"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2453","type":"APR-DRG"}],"standard_charges":[{"minimum":6920,"maximum":6920,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6920,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6920,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6920,"methodology":"case rate"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24530","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":780.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":377.48,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":377.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":377.48,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24535","type":"CPT"}],"standard_charges":[{"minimum":607.15,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1255.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":607.15,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":607.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":607.15,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24538","type":"CPT"}],"standard_charges":[{"minimum":834.65,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1726.23,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":834.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":834.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":834.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2454","type":"APR-DRG"}],"standard_charges":[{"minimum":13080,"maximum":13080,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13080,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13080,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13080,"methodology":"case rate"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24545","type":"CPT"}],"standard_charges":[{"minimum":974.89,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2015.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":974.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":974.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":974.89,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24546","type":"CPT"}],"standard_charges":[{"minimum":1088.82,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2251.83,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1088.82,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1088.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1088.82,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24560","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":656.88,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":317.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":317.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":317.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24565","type":"CPT"}],"standard_charges":[{"minimum":528.19,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1092.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":528.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":528.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":528.19,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24566","type":"CPT"}],"standard_charges":[{"minimum":761.46,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1574.8,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":761.46,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":761.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":761.46,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24575","type":"CPT"}],"standard_charges":[{"minimum":772.99,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1598.28,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":772.99,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":772.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":772.99,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24576","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":696.5,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":336.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":336.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":336.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24577","type":"CPT"}],"standard_charges":[{"minimum":541.53,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1119.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":541.53,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":541.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":541.53,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24579","type":"CPT"}],"standard_charges":[{"minimum":879.71,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1819.2,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":879.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":879.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":879.71,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT HUMERUS FRACTURE","code_information":[{"code":"24582","type":"CPT"}],"standard_charges":[{"minimum":862.05,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1782.68,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":862.05,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":862.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":862.05,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT ELBOW FRACTURE","code_information":[{"code":"24586","type":"CPT"}],"standard_charges":[{"minimum":1140.74,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2359.1,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1140.74,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1140.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1140.74,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT ELBOW FRACTURE","code_information":[{"code":"24587","type":"CPT"}],"standard_charges":[{"minimum":1142.54,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2362.73,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1142.54,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1142.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1142.54,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT ELBOW DISLOCATION","code_information":[{"code":"24600","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":759.44,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":367.39,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":367.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":367.39,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT ELBOW DISLOCATION","code_information":[{"code":"24605","type":"CPT"}],"standard_charges":[{"minimum":508.72,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1051.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":508.72,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":508.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":508.72,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2461","type":"APR-DRG"}],"standard_charges":[{"minimum":3651,"maximum":3651,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3651,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3651,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3651,"methodology":"case rate"}]}]},{"description":"TREAT ELBOW DISLOCATION","code_information":[{"code":"24615","type":"CPT"}],"standard_charges":[{"minimum":753.88,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1558.81,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":753.88,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":753.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":753.88,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2462","type":"APR-DRG"}],"standard_charges":[{"minimum":4547,"maximum":4547,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4547,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4547,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4547,"methodology":"case rate"}]}]},{"description":"TREAT ELBOW FRACTURE","code_information":[{"code":"24620","type":"CPT"}],"standard_charges":[{"minimum":623.73,"maximum":2947,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1289.75,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2897,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2295,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":623.73,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":623.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":623.73,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2463","type":"APR-DRG"}],"standard_charges":[{"minimum":6955,"maximum":6955,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6955,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6955,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6955,"methodology":"case rate"}]}]},{"description":"TREAT ELBOW FRACTURE","code_information":[{"code":"24635","type":"CPT"}],"standard_charges":[{"minimum":714.59,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1477.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":714.59,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":714.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":714.59,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2464","type":"APR-DRG"}],"standard_charges":[{"minimum":12136,"maximum":12136,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12136,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12136,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12136,"methodology":"case rate"}]}]},{"description":"TREAT ELBOW DISLOCATION","code_information":[{"code":"24640","type":"CPT"}],"standard_charges":[{"minimum":84.37,"maximum":1998,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":174.24,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":84.37,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":84.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":84.37,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT RADIUS FRACTURE","code_information":[{"code":"24650","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":3571,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":403.16,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":547.03,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":264.63,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":264.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":264.63,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT RADIUS FRACTURE","code_information":[{"code":"24655","type":"CPT"}],"standard_charges":[{"minimum":432.65,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":894.94,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":432.65,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":432.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":432.65,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT RADIUS FRACTURE","code_information":[{"code":"24665","type":"CPT"}],"standard_charges":[{"minimum":694.76,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1436.71,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":694.76,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":694.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":694.76,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"TREAT RADIUS FRACTURE","code_information":[{"code":"24666","type":"CPT"}],"standard_charges":[{"minimum":773.35,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1599.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":773.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":773.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":773.35,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"TREAT ULNAR FRACTURE","code_information":[{"code":"24670","type":"CPT"}],"standard_charges":[{"minimum":211.94,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":596.16,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":288.43,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"TREAT ULNAR FRACTURE","code_information":[{"code":"24675","type":"CPT"}],"standard_charges":[{"minimum":446.71,"maximum":2076,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":923.49,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":446.71,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":446.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":446.71,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT ULNAR FRACTURE","code_information":[{"code":"24685","type":"CPT"}],"standard_charges":[{"minimum":690.79,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1428.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":690.79,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":690.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":690.79,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2471","type":"APR-DRG"}],"standard_charges":[{"minimum":2947,"maximum":2947,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2947,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2947,"methodology":"case rate"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2472","type":"APR-DRG"}],"standard_charges":[{"minimum":3922,"maximum":3922,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3922,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3922,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3922,"methodology":"case rate"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2473","type":"APR-DRG"}],"standard_charges":[{"minimum":6350,"maximum":6350,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6350,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6350,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6350,"methodology":"case rate"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2474","type":"APR-DRG"}],"standard_charges":[{"minimum":12138,"maximum":12138,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":12138,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":12138,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":12138,"methodology":"case rate"}]}]},{"description":"FUSION OF ELBOW JOINT","code_information":[{"code":"24800","type":"CPT"}],"standard_charges":[{"minimum":878.27,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3732.14,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3060,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1815.77,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":878.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":878.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":878.27,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"FUSION/GRAFT OF ELBOW JOINT","code_information":[{"code":"24802","type":"CPT"}],"standard_charges":[{"minimum":1053.49,"maximum":13759.66,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2178.09,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1053.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1053.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1053.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":13759.66,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":13626.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":13492.48,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":13358.89,"methodology":"fee schedule"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2481","type":"APR-DRG"}],"standard_charges":[{"minimum":3276,"maximum":3276,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3276,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3276,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3276,"methodology":"case rate"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2482","type":"APR-DRG"}],"standard_charges":[{"minimum":4453,"maximum":4453,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":4453,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":4453,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":4453,"methodology":"case rate"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2483","type":"APR-DRG"}],"standard_charges":[{"minimum":6773,"maximum":6773,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":6773,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":6773,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":6773,"methodology":"case rate"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2484","type":"APR-DRG"}],"standard_charges":[{"minimum":13241,"maximum":13241,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":13241,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":13241,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":13241,"methodology":"case rate"}]}]},{"description":"AMPUTATION OF UPPER ARM","code_information":[{"code":"24900","type":"CPT"}],"standard_charges":[{"minimum":776.24,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1605.38,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":776.24,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":776.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":776.24,"methodology":"fee schedule"}]}]},{"description":"OTHER GASTROENTERITIS, NAUSEA AND VOMITING","code_information":[{"code":"2491","type":"APR-DRG"}],"standard_charges":[{"minimum":2971,"maximum":2971,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":2971,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":2971,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":2971,"methodology":"case rate"}]}]},{"description":"OTHER GASTROENTERITIS, NAUSEA AND VOMITING","code_information":[{"code":"2492","type":"APR-DRG"}],"standard_charges":[{"minimum":3543,"maximum":3543,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":3543,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":3543,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":3543,"methodology":"case rate"}]}]},{"description":"AMPUTATION OF UPPER ARM","code_information":[{"code":"24920","type":"CPT"}],"standard_charges":[{"minimum":773.35,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1598.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":773.35,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":773.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":773.35,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FOLLOW-UP SURGERY","code_information":[{"code":"24925","type":"CPT"}],"standard_charges":[{"minimum":602.82,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1246.65,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":602.82,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":602.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":602.82,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"OTHER GASTROENTERITIS, NAUSEA AND VOMITING","code_information":[{"code":"2493","type":"APR-DRG"}],"standard_charges":[{"minimum":5212,"maximum":5212,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":5212,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":5212,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":5212,"methodology":"case rate"}]}]},{"description":"AMPUTATION FOLLOW-UP SURGERY","code_information":[{"code":"24930","type":"CPT"}],"standard_charges":[{"minimum":814.82,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1684.56,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":814.82,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":814.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":814.82,"methodology":"fee schedule"}]}]},{"description":"AMPUTATE UPPER ARM  IMPLANT","code_information":[{"code":"24931","type":"CPT"}],"standard_charges":[{"minimum":978.14,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2022.59,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":978.14,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":978.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":978.14,"methodology":"fee schedule"}]}]},{"description":"REVISION OF AMPUTATION","code_information":[{"code":"24935","type":"CPT"}],"standard_charges":[{"minimum":1285.32,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2657.84,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1285.32,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1285.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1285.32,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"OTHER GASTROENTERITIS, NAUSEA AND VOMITING","code_information":[{"code":"2494","type":"APR-DRG"}],"standard_charges":[{"minimum":10633,"maximum":10633,"setting":"inpatient","payers_information":[{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":10633,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":10633,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":10633,"methodology":"case rate"}]}]},{"description":"REVISION OF UPPER ARM","code_information":[{"code":"24940","type":"CPT"}],"standard_charges":[{"minimum":1907.77,"maximum":7926.5,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3776,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":7926.5,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":4179.34,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6159,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":4880,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":6300,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1907.77,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1907.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1907.77,"methodology":"fee schedule"}]}]},{"description":"UPPER ARM/ELBOW SURGERY","code_information":[{"code":"24999","type":"CPT"}],"standard_charges":[{"minimum":153.97,"maximum":2639.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1795,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1420,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":1829,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":218.3,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":216.18,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":214.06,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":211.94,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC","code_information":[{"code":"250","type":"MS-DRG"}],"standard_charges":[{"minimum":33374.31,"maximum":52072.08,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52072.08,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":39055.28,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":39055.28,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33374.31,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":33374.31,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":34293.47,"methodology":"case rate"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40723,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":33621,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":46278,"methodology":"case rate"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":48067.56,"methodology":"case rate"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":48548.24,"methodology":"case rate"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":49509.59,"methodology":"case rate"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":49028.92,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":48067.56,"methodology":"case rate"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":48067.56,"methodology":"case rate"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":48067.56,"methodology":"case rate"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":48548.24,"methodology":"case rate"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":48067.56,"methodology":"case rate"}]}]},{"description":"INCISION OF TENDON SHEATH","code_information":[{"code":"25000","type":"CPT"}],"standard_charges":[{"minimum":367.75,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":760.47,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":367.75,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":367.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":367.75,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"INCISE FLEXOR CARPI RADIALIS","code_information":[{"code":"25001","type":"CPT"}],"standard_charges":[{"minimum":368.47,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":761.6,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.47,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.47,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"DECOMPRESS FOREARM 1 SPACE","code_information":[{"code":"25020","type":"CPT"}],"standard_charges":[{"minimum":785.97,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1625.12,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":785.97,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":785.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":785.97,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"DECOMPRESS FOREARM 1 SPACE","code_information":[{"code":"25023","type":"CPT"}],"standard_charges":[{"minimum":1377.62,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2848.82,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1377.62,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1377.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1377.62,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"DECOMPRESS FOREARM 2 SPACES","code_information":[{"code":"25024","type":"CPT"}],"standard_charges":[{"minimum":815.9,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1687.07,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":815.9,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":815.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":815.9,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"DECOMPRESS FOREARM 2 SPACES","code_information":[{"code":"25025","type":"CPT"}],"standard_charges":[{"minimum":1286.4,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":3053,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":3021.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2525,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":2660.35,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":1286.4,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":1286.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":1286.4,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF FOREARM LESION","code_information":[{"code":"25028","type":"CPT"}],"standard_charges":[{"minimum":732.25,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1514,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":732.25,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":732.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":732.25,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF FOREARM BURSA","code_information":[{"code":"25031","type":"CPT"}],"standard_charges":[{"minimum":391.18,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":808.98,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":391.18,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":391.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":391.18,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1512.76,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1498.07,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1483.38,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1468.69,"methodology":"fee schedule"}]}]},{"description":"TREAT FOREARM BONE LESION","code_information":[{"code":"25035","type":"CPT"}],"standard_charges":[{"minimum":620.49,"maximum":6975.36,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":2262,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1283.04,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":620.49,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":620.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":620.49,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":6975.36,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":6907.64,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":6839.92,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":6772.19,"methodology":"fee schedule"}]}]},{"description":"EXPLORE/TREAT WRIST JOINT","code_information":[{"code":"25040","type":"CPT"}],"standard_charges":[{"minimum":591.64,"maximum":4367,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":4367,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":4244.02,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":3571,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":1223.53,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3360,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":2661,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":3423,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":591.64,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":591.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":591.64,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":3138.99,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":3108.52,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":3078.04,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":3047.56,"methodology":"fee schedule"}]}]},{"description":"BIOPSY FOREARM SOFT TISSUES","code_information":[{"code":"25065","type":"CPT"}],"standard_charges":[{"minimum":165.85,"maximum":2472,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2076,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborhood","standard_charge_dollar":1971.12,"methodology":"fee schedule"},{"payer_name":"Cigna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Cigna","plan_name":"Commercial|PPO","standard_charge_dollar":1998,"methodology":"case rate"},{"payer_name":"Coventry","plan_name":"Commercial|All Plans","standard_charge_percentage":53,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"Humana","plan_name":"Commercial|All Plans","standard_charge_dollar":342.87,"methodology":"fee schedule"},{"payer_name":"Multiplan","plan_name":"Commercial|All Plans","standard_charge_percentage":81.7,"estimated_amount": 999999999,"methodology":"percent of total billed charges"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2429,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Navigate","standard_charge_dollar":1925,"methodology":"case rate"},{"payer_name":"United","plan_name":"Commercial|Options","standard_charge_dollar":2472,"methodology":"case rate"},{"payer_name":"Health Choice","plan_name":"Medicaid|All Plans","standard_charge_dollar":165.85,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicaid|All Plans","standard_charge_dollar":165.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicaid|All Plans","standard_charge_dollar":165.85,"methodology":"fee schedule"},{"payer_name":"Alignment Health","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"Devoted HP","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.33,"methodology":"fee schedule"},{"payer_name":"Fresenius","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.98,"methodology":"fee schedule"},{"payer_name":"Health Choice","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Humana","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"Mercy Care","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Medicare|All Plans","standard_charge_dollar":1550.63,"methodology":"fee schedule"},{"payer_name":"WellCare","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.27,"methodology":"fee schedule"}]}]},{"description":"BIOPSY FOREARM SOFT TISSUES","code_information":[{"code":"25066","type":"CPT"}],"standard_charges":[{"minimum":389.74,"maximum":3423,"setting":"outpatient","payers_information":[{"payer_name":"Aetna","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"Aetna","plan_name":"Commercial|PPO","standard_charge_dollar":2628,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|MaricopaFocus","standard_charge_dollar":2639.62,"methodology":"fee schedule"},{"payer_name":"BCBS - AZ","plan_name":"Commercial|Neighborho